When Doctors Don't Know What's Wrong

The first patient I've ever seen, which is the first year of residency was a litany of complaints, one of which I can not remember now, except one: he had headaches. I remember was a headache not because they spent so much time with them discussing, but the opposite: that time I knew next to nothing headaches, and somehow managed to end a visit without ever having his deal at all, even though they were the primary reason why come to me.

Then alternate between the neurology service and actually learned quite a bit headache. At a time when the patient came back to me a few months later, I distinctly remember at this point not only to care about the headaches, but are actually excited to discuss with them.

Many times I thought back to that experience when I'm faced with a patient who has a complaint, I can not figure out, and I thought it would be useful to describe the various reactions of patients to doctors in general, when "t figure out what's wrong why they are and what you can do for patients is to improve the chances of getting this type of situation is in good hands.

The scientific method

Believing this unusual idea in itself is not unusual. Believing without evidence of an unusual idea, but it certainly is. Similarly, rational thought without the credibility to refute them when they disprovable is also unusual. Unfortunately, patients are often guilty of thinking the first error ("The incidence of diarrhea caused by a brain tumor") and doctors of the second ("brain tumors do not cause diarrhea, so you can not have a brain tumor"), leading in both cases, the court doctor-patient relationship, missed diagnosis, and unnecessary suffering. Doctors are often unwilling to test the patient to be necessary, because I think that the patient is convinced that what is wrong with the unusual, sometimes suggest that the patient's symptoms are psychosomatic, if you run all the tests are negative, but the symptoms persist, and sometimes the patient's symptoms are not explained it finds implausible, but refuses to pursue further the cause of the symptoms.

Sometimes these decisions are correct, and sometimes they do not --- but the experience that they are on the receiving end is always frustrating for patients. However, as a medical doctor by training and not the best strategy to use in these situations may not be best to make sure that you have passed judgments based on sound scientific reasoning rather than unconscious bias.

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