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So why is perception of relevance to medical practice? Perception affects our behaviour and activity. We perceive we in control of what we do, but in reality you are much more controlled by your contigencies and perceptual patterning, language and the extent that you can manipulate the symbols and environment to achieve the outcomes you prefer than you might think. The extent to which people perceive themselves to be threatened or at risk influences their use of health care systems, consultation and health behaviour, as well as dictating their risk-taking behaviour (other people get sick and die, but I bet you don’t really realise that it will happen to you too one day, do you? No. See? Perceptual distortion. How you perceive your patients (compare how you perceive your patients now to how you will perceive them when you do your House Officer year) and how they perceive you will depend on a range of factors beyond your personal control, but which can be modified by careful attention to your habits of thought. The perceptions of patients are influenced by their expectations. What they perceive will depend on what things mean to them. What things mean will depend on their past experience and their knowledge. The importance of good communication is crucial. When carefully well prepared, people can be very strong, when unprepared, very afraid. Pain can be better controlled through an understanding of perception (see my MS lecture on pain) while a more accurate perception of the level of pain patients have to tolerate may help improve care for a wide range of surgical, burns, arthritis and cancer patients, to name just a few. Specific deficits in perceptual ability can be vital in diagnosis and assessing neurological impairments, and optimizing rehabilitation measures. Diagnosis is a process of pattern recognition - subtle shifts in the focus of attention can block new stimulus configurations and prevent the detection of a rare condition, and perhaps delay vital treatment. In paediatrics, geriatrics, and every branch of medicine in between perception is central to what occurs, but mostly you wont think about it, though it will affect profoundly what you do, why you do it, and of course its consequences.Oh yes, and it also affects the answers you give to exams too, because of how you perceive the questions…..