Alvan Feinstein’s Science of Clinical Judgment: A Solution to the Gaps between Research and Clinical Practice

Abstract

Following the Second World War, a prominent professional challenge in medicine, highlighted by practitioners, has been the divide between research and clinical practice. Medical authority was rooted in specific conditions of professional autonomy. Yet, there was a prevailing notion that medical decisions were scientifically elusive due to their reliance on data acquired and analyzed by individuals. While laboratory research epitomized scientific order and rigor, clinical practice was entrenched in a tradition that endowed practitioners with undue authority. Much of Alvan Feinstein’s post-war research and academic contributions in the American context be-came pivotal both in the development of a science of clinical judgment and in the endeavor to bridge the gap between clinical practice and research. This paper underscores certain facets of his proposal. This approach is of interest to healthcare professionals as it champions the humanistic foundations of the classical concept of Clinical Judgment, whilst also advocating for modern scientific rationalism. It emphasizes training the physician’s perceptual machinery to enhance observation mechanisms and the accurate categorization of patients.

Keywords

• clinical epidemiology
• clinical reasoning
• evidence-based medicine
• medical ethics