Once upon a time physicians were allowed to admit that we did not know everything. This is no longer acceptable by many of the organizations that pay. A diagnosis of “undiagnosed condition” was once upon a time admissible. I am not sure that all physicians have become much smarter. Unfortunately, at the present time, a diagnosis is needed if payment is to be made by most entities that pay physicians fees. In the interest of both our professional integrity as well as the possible errors that can be incorporated into a patient’s “Electronic Medical Record”, I would hope that the luxury of being intellectually honest could be restored to our profession without penalty.