How Your Diagnosis Is Made

Be sure to bring your PatientAction.com online Health History with you to each new doctor visit. Bring a list of each medication you are on and their doses or the containers for each medication you are on, including any over-the-counter drugs, herbs, supplements, vitamins. Tell your doctor about any and all symptoms you have been having. This will help your doctor make the diagnosis. Sometimes different illnesses will have similar symptoms so it is important for you to communicate this information to your doctor.

When you are seen by your primary doctor, s/he will do an assessment of your 12 body systems in order to diagnose any dysfunction or disease. Along with asking you questions, the doctor will complete the assessment through the use of inspection, palpation (touch), auscultation (listening with a stethoscope), and/or percussion (tapping). The information gathered will help make a tentative diagnosis of your medical problem. In order to confirm the tentative diagnosis, the doctor may order blood work, Xrays, Magnetic Resonant Imaging (MRI), Computerized Tomography (C-T Scan), Ultrasound, colonoscopy, endoscopy, electrocardiogram (EKG) , electroencephalogram (EEG), Stress Test, biopsy, urine testing, sputum testing, wound drainage testing, Barium swallows or enemas, angiograms, etc. Have a conversation with your doctor about which labs and diagnostic centers s/he is will be using to help make your diagnosis. You want to make sure your health insurance company will pay for those facilities.

The results of any of these tests, performed by highly trained technicians or doctors, will be reviewed by the head doctor of each respective department, and will be shared with your primary doctor in either confirming or discounting the tentative diagnosis. Once that diagnosis is confirmed, your physician will determine the best treatment for you. If that diagnosis is not confirmed, your primary physician may send you for more tests or to a specialist for further work-up or treatment.

If you are not comfortable with your diagnosis, prognosis, or treatment plans from your primary doctor, be sure to get a second opinion, which most insurance companies will encourage you to do and pay for. Don’t be afraid to let your primary doctor know that you desire to get a second opinion. This will allow you to bring the findings from the second doctor back to your primary doctor for further discussion. Be sure to seek out that second opinion from a doctor unaffiliated with your primary doctor or hospital-system. The second doctor may either agree or disagree with the diagnosis and treatment recommended by your primary doctor. This is something you need to be prepared for. In some rare instances, you may desire a third opinion. This, too, is fine but don’t run yourself ragged trying to find the doctor with the perfect fix. You will spend lots of energy and money doing so. It is most important to find a doctor you feel comfortable with and trust. Remember that doctors network and any professional who has a proven successful method of treatment will be sharing that with international colleagues.

Make sure you ask to get a written report of all diagnostic test results. This guarantees that your doctor has read them! If you don’t get a copy of them within one week, CALL YOUR DOCTOR.

TERMINOLOGY:

Diagnosis: The nature of a disease; the identification of an illness.

Health Care Delivery System: full range of health care services available to health care consumers seeking prevention, diagnosis, treatment, or rehabilitation of health problems.

Health Care Team: specially trained personnel, including doctors & nurses, who collaboratively work together to help health care consumers meet their health care needs with the best possible outcome.

Intravenous Pyelogram: diagnostic procedure in which dye is injected into the vein and watched as it goes through the kidneys and urinary system; used to detect for kidney stones.

Prognosis: The expected course of a disease.

Anecdotes:

My 31 year old brother-in-law, Marty, was admitted to the hospital with severe right lower abdominal pain and right lower back pain which was a classical symptom of kidney stones. The admitting doctor thought Marty might have been suffering from kidney stones. An Intravenous Pyelogram (IVP) was ordered to see if he had stones. In this test, they inject dye into the patient and watch as it goes through the urinary system. When the admitting doctor spoke with the radiologist (medical doctor who performs & evaluates radiological tests) who performed the IVP, the preliminary verbal report came back as negative for kidney stones. Marty responded to the Intravenous antibiotics and was sent home after 2 days. Upon discharge, his medical chart was sent to the medical records department where it was filed. Unfortunately for Marty, the official written radiologist’s report showed no kidney stones, but did show a suspicious looking mass in the colon (large intestine) which was pressing on the ureter (tube that delivers urine from kidney to bladder). That was why he was having pain in his lower right abdomen and pain in the right lower back area. The admitting doctor never read the report as it was sent to Marty’s file tucked away in the medical records department. As a result, Marty walked around undiagnosed and untreated for 18 months, until he was finally diagnosed with Stage 4 Colon Cancer. He died one month after his diagnosis, at the age of 33. Had Marty requested to see the written results of his IVP, he might be alive today.

A father was playing ball with his 2 young children. His daughter got hit in the head with the hard ball. She seemed to be fine. On the third day after that incident, she started holding her head and crying that her head hurt her. The parents took her to the Emergency Room of the local hospital. Despite giving the attending doctor the history of the head trauma, the doctor diagnosed her as having a virus and proceeded to discharge her home to rest. The parents just did not feel comfortable with that. Their gut instinct told them that something was seriously wrong. When they asked the doctor to order a C-T Scan of their daughter’s head, he got insulted and insolent. They had to refuse to take their child home and demand that the test be done. The doctor was totally surprised when the test showed bleeding into the brain, most likely as a result of the brain trauma 3 days before. Had the parents taken their child home to sleep off the virus that night, the child probably would never have woken up.

Sometimes, the doctor does everything right and there is still no diagnosis! I took a bad step in my bathroom one evening and immediately felt “something” in my right leg, resulting in terrible pain in my right calf. After an Xray showed no noticeable injury, my orthopedic doctor ordered an MRI. The MRI¬† came back negative for any broken bones or muscle problems. At that point, he told me that I didn’t have a musculo-skeletal problem. We talked about what else might be causing the pain, and he decided to send me to a vascular surgeon¬† for an ultrasound to see if I had a blood clot. The Ultrasound came back negative for a blood clot. I asked that doctor what might be causing my pain. He said that the Ultrasound did show that a vein in my leg had reflux (backward flow of blood) and he thought that might be causing my pain. He suggested I wait for two weeks to see if the pain would go away, and if not, to call him to pursue treatment of that bad vein. I felt good knowing that these doctors did the proper tests to try and find out what was wrong with me.

It’s your child. Go with your parental gut instinct. Your child doesn’t have a voice so you need to advocate for them. Don’t be afraid to question and challenge your doctor when your gut tells you that something is not right. The literature shows that 1 out of 10 diagnoses are incorrect. You have a voice… use it!

Comments are closed