Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. Diagnosing an illness is an art. A diagnostician needs to be one part scholar, one part detective, and four parts artist. He has to be a good listener, open minded, and capable of assimilating a large amount of sometimes confusing data into an accurate picture of a disease process. A diagnostician must also be humble, capable of seeking help and counsel from multiple sources.
A diagnostician’s most valuable tool is a reliable patient. Just as Sherlock Holmes needed Dr. Watson, the most brilliant diagnostician needs a sidekick, his patient and partner. When I went to medical school 35 years ago, I was taught that 95% of diagnosis comes from listening to the patient and gathering a good history. Not only was my teacher brilliant, but if you listen to your patient long enough, most patients will lead you to a proper diagnosis. In, “I’m Not a Doc, But …” I reviewed the importance of encouraging your patient to play doctor.
Modern medicine offers a host of diagnostic tools designed to help the physician in his diagnostic process. CTs, MRIs, lab tests, and a host of other diagnostic tests are often employed in figuring out what the cause(s) of a patient’s illness is (are). Unfortunately, both patients and physicians have become all too dependent on these modern marvels.
When there is no clear diagnosis, your doc will formulate a “differential diagnosis,” a list of all the possible causes for what ails you and formulate a plan to help treat you. Be a great sidekick/partner. Work hard to be accurate in your description of your symptoms and the historical facts surrounding your illness. The life you save may be your own.
Stewart Segal is a family physician who blogs at Livewellthy.org.
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