Wednesday, April 5, 2017

Fisher's Rules.

Hello Everybody!

So today I will be telling you guys about the “Fisher’s rules” that I came across while striving to develop good clinical skills while doing my internship!

So these rules are basically clinical maxims collected from observing C. Miller Fisher, a clinician of legendary diagnostic acumen. Some of these axioms are particularly helpful to bear in mind and are relevant for Clinical Reasoning and useful as diagnostic Principles.

So here we go, while seeing the patient for the first time we better keep the following 6 rules in our mind.

1) In arriving at a clinical diagnosis, think of the five most common findings (historical, physical findings, or laboratory) found in a given disorder.

If at least three of these five are not present in a given patient, the diagnosis is likely to be wrong.

2) Resist the temptation to prematurely place a case or disorder into a diagnostic cubbyhole that fits poorly.

Allowing it to remain unknown stimulates continuing activity and thought.

3) The details of a case are important; their analysis distinguishes the expert from the journeyman.

4) Pay particular attention to the specifics of the patient with a known diagnosis; it will be helpful later when similar phenomena occur in an unknown case.

5) Fully accept what you have heard or read only when you have verified it yourself.

6) Maintain a lively interest in patients as people.

I found these extremely useful while seeing patients in real and so thought of sharing these.

Medicine in practice is more than just Studying the Standard textbooks, It's an Art that we should all strive to Master,so we can help our patients better.

Its a long journey ahead... Let's Learn Together!



  1. Excellent area not usually addressed. Who is Fisher, where did he teach/practice? Are there any books written that he has written??

    1. Hello ee Mann ...
      Thank you for your kind words.

      So yeah...
      Charles Miller Fisher, usually known as C. Miller Fisher,was a great neurologist who studied and gave an idea on the lacunar strokes and it's etiopathogenesis,and the description of a variant form of Guillain–BarrĂ© syndrome which bears his name.

    2. He practiced in United States .. I haven't come across any books written by him per say .. but if you do. .. do share it.

    3. Yeah ...I will try to collect the reliable information we need

    4. Yes Please..Do so.. and Thank you Naveen!


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