I believe that Competent medicine means to treat the person, not the disease. Rely heavily on the history and the exam, as well as your own experience and intuition – and not spend time ordering and chasing lab tests and x-rays. These are to augment a physician's skill, not try and make a diagnosis apart from intelligent interpretation of signs and symptoms.
I am of the old-school, which feels that if you truly listen to patients, they will give you the diagnosis, along with having a broad base of education and experience to recognize a condition when it presents itself. No shotgun approach with me. It's more sleuthing until it cones down on what must be the accurate diagnosis. And not a lot of extraneous testing, which often only reveals red herrings that then have to be chased down. That is time-consuming and expensive, as well as frustrating to the patients.
A little time and smarts at the onset can save hours or weeks of confusion and missteps in the long run.
Born in the Midwest, grew up in Hollywood, CA, educated in Boston, moved to the South for several years with horses and rescue dogs. Now I've come back to find a wonderful home in the beautiful Northwest. Two daughters in Seattle (a corporate attorney and a Professor at the University of Washington) and just got my first grandbaby!