This happens many a times in my and my colleague’s regular practice that we come across patients suffering from ‘something‘ which exhibits multiple symptoms and multiple pathological distresses. The expectations from any patient would be to get a quick cure (and in the best case scenario in that visit itself) and return back to the normalcy. I would not blame that for having such expectations. Like all my colleagues, I too have been a patient sometimes to some doctor. So we all understand these expectations. However, many a times these patients do get disappointed and few antagonized too when things get delayed to get this cure. One way to avoid this disappointment is probably to understand how we doctors approach diagnosing. In this blog, I will try to unravel some tricks of the trade or give you some ‘behind-the-screen’ view of what typically goes on in the doctor’s brain while the patient is trying to narrate his/her sufferings to his/her doctor.
Before I go further, there are few things I would like to point out. First it might be worthwhile to review what “diagnosis” means. The dictionary meaning of diagnosis is
“to determine the identity of (a disease, illness, etc.) by a medical examination”.
Notice presence of the word ‘identity‘ in this definition and absence of the word ‘cure‘ in the same definition. Notice that at the start of above paragraph – I said suffering from ‘something‘. Diagnosis is all about giving a ‘name‘ to this ‘something‘. Diagnosis is not about subscribing a cure. As subtle as this may sound – in my professional experience I do come across many who confuse between a ‘diagnosis‘ and a ‘cure‘.
Second, cures or a treatment are always associated with disease/s or an illnesses. This means that for us to prescribe a treatment we doctors should have a reasonably good deduction or at a minimum a hypothesis of the name of the disease. And many a times attributing one possible name from millions of diseases out there can be quite a task and a possible reason for delays in patients getting the proper treatment. So next time when you are sitting in front of your doctor trying to describe your sufferings with the hope of getting a remedial treatment at the end of the conversation – keep in mind that your doctor in his/her mind may simply be trying to solve a puzzle of connecting the symptoms to a potential disease name. If we are able to connect it to the name, you would get the treatment (or the plan for the treatment) immediately. But if we are not, you would have to wait. Our focus then is to ease the patient by immediately addressing to their immediate symptoms and in parallel run some pathological tests – the aim of that again is to help us get to the ‘name‘. There are various ways in which we go about on this ‘name-finding’ mission (also called as the process of diagnosis). I will cover some of that in one of my future blog.
Ability to quickly diagnose depends on lots of things – how well you describe your symptoms/ailments; how well we doctors listen to that; how well we can sense the missing clues; our past experience levels in dealing with similar symptoms/ailments; or simply in how well we build our hypothesis based on what we hear from our patients. And both from the patient perspective and even from the doctor’s perspective – the need is to correctly and quickly complete this diagnosis process and move on to the treatment phase. The relief to the patient comes from the treatment phase and needless to say we also typically earn our bread-and-butter majorly from this phase only.
So to conclude – you might have heard this saying many a times- “what is in the name?“. Well, for many things in life it may not mean much – but when it comes to treating diseases, as I described above, for we doctors it means a lot! As patients you may or may not care of the name – but you should certainly care if your doctor knows about your disease name or not.
Tags: Diagnosis vs. Treatment, Disease Name, Doctor - Patient Relationship, How do doctors diagnose or treat?
