AN UNDERSTANDING of the process of clinical decision is essential to the formulation of applications of the computer to clinical medicine. Although the computer has proved its worth in some clinical situations, results have been disappointing with more pervasive involvement of automation. Of the various health care personnel, the role and function of the clinician is least defined. The public clamor for an accounting of his activities has led to a concentration on attempted quantification of these activities in terms of visible diagnostic and therapeutic procedures that often bear scant relation to professional standards of quality of care.
The unique task of the clinician is primarily a goal-directed intellectual process involving decision-making leading to courses of action. This function of the clinician defies easy mensuration and is often summarily dismissed as an art, some form of intuition, mysticism, or even charlatanism. Some degree of formalization of this process is attainable,