Patients diagnosing themselves

  1. Don't get me wrong; I am all for being your own advocate in your health care. Everyone should have a clear understanding of what is being done to/for them medically and what the ramifications are. But it does kinda drive me up a wall when patients come into our office having already "diagnosed" themselves (usually via the internet ) and completely shutting off the the assessment/suggestions of the doctor/NP/PA.

    IBS is one frequent example. No one wants to hear that that could be their dx. Needs to be something you can cure with atbx and fix RIGHT NOW. Had a gal last week wanting all manner of stool testing done when she was classically IBS. NP ordered what he felt was appropriate and held his ground on all the extra nonsense; said she needed to give the treatment longer than one day to work . Is it any wonder that health care is so outrageously expensive when people with no medical training want to play doctor and direct what tests are to be done? Regardless of whether or not the tests are clinically indicated, the provider almost feels obliged to order them because we are in such a litiguous society (U.S.) And truly, I don't care what your family member who is in the profession thinks. If they aren't treating you, they aren't ordering the tests. If you want that family member to be your doctor, don't come into our office and ask our opinion.

    Rant over .

    Feel better, thanks!
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  2. 19 Comments

  3. by   nurseunderwater
    I have a friend like that....only thing is she LOVES to dx everyone else.....internet physician. she scares people. :uhoh21:
  4. by   tmiller027
    Quote from nurseunderwater
    I have a friend like that....only thing is she LOVES to dx everyone else.....internet physician. she scares people. :uhoh21:
    My mother in law is like this. My wife would go to the Dr. For something minor, he'd say it was something simple and give her meds, yet her mom, a hairdresser woudl tell her.."oh no, so and so at work had the same thing last year and she died of cancer two months later!" or something stupid like that. My wife always believed it for years, until I finally drilled into her head that unless they pass out M.D's in cosmetology school, to listen to the Dr.
  5. by   canoehead
    The medical assistants in my doctor's office often offer a diagnosis to the patient before the doc comes in, but they don't offer any information. Just offhand -" Have you ever heard or Slingman's Paralytic Syndrome?...no?.....ummmhmmmm...."
  6. by   Mithrah
    What is IBS???!?!?
  7. by   KBnursestudent
    To be fair to the patient I had a condition that looked just like IBS and it wasn't I could easily have been diagnosed with it but luckily my doc thought to taest me for Celiac disease. (cureable BTW) I thought it was IBS and I had all the symptoms but went to the doc anyway and I am glad I was wrong but you knwo not all things taht look like obvious IBS are that. A lot of people are diagnosed with IBS and actually have somethign else like Chrons, or Celiac disease.

    Quote from Nurse Ratched
    Don't get me wrong; I am all for being your own advocate in your health care. Everyone should have a clear understanding of what is being done to/for them medically and what the ramifications are. But it does kinda drive me up a wall when patients come into our office having already "diagnosed" themselves (usually via the internet ) and completely shutting off the the assessment/suggestions of the doctor/NP/PA.

    IBS is one frequent example. No one wants to hear that that could be their dx. Needs to be something you can cure with atbx and fix RIGHT NOW. Had a gal last week wanting all manner of stool testing done when she was classically IBS. NP ordered what he felt was appropriate and held his ground on all the extra nonsense; said she needed to give the treatment longer than one day to work . Is it any wonder that health care is so outrageously expensive when people with no medical training want to play doctor and direct what tests are to be done? Regardless of whether or not the tests are clinically indicated, the provider almost feels obliged to order them because we are in such a litiguous society (U.S.) And truly, I don't care what your family member who is in the profession thinks. If they aren't treating you, they aren't ordering the tests. If you want that family member to be your doctor, don't come into our office and ask our opinion.

    Rant over .

    Feel better, thanks!
  8. by   KBnursestudent
    Oh taht woudl make me mad! :angryfire the aids have no right to offer any kind of dx or info at all. it is an ethics issue. that is just wrong. They do not knwo what they are talkign about. I knew CNA's that would do taht. They were wanna be nurses and yet they were not goign to nursing school and did have opportunity. they just wnated to make everyone think they were knowledgeable and they were not. they had no clue. I was a CNA at the time too. I never said a word to the Pt about DX. I was told taht is crossing the ethical lines for a CNA and it was not to be done.

    Quote from canoehead
    The medical assistants in my doctor's office often offer a diagnosis to the patient before the doc comes in, but they don't offer any information. Just offhand -" Have you ever heard or Slingman's Paralytic Syndrome?...no?.....ummmhmmmm...."
  9. by   KBnursestudent
    Quote from Mithrah
    What is IBS???!?!?
    IBS is Irritable Bowel Syndrome
  10. by   Nurse Ratched
    I hesitated to use a specific example since on a board this size someone would have a story about how they were misdiagnosed. I'm glad they caught your true illness, KBnursestudent. (In the example I gave, the person also had a family hx of two first degree relatives who were also dx'd with IBS, and were responding well to meds, as is this person now that she is actually taking them lol. She didn't mention the family history until after the NP had expressed his thought on the diagnosis, and then it was, "That can't be; that's what my Mom and sister have. It has to be something else.") This is an extreme example, I grant you, but it's the extreme cases that provoke rants on this board lol.

    Our aides/techs are great - very careful not to do anything but what they're supposed to. Doesn't stop patients from asking questions of the first person they see in a uniform, but they are quick to say, "I'm a nursing assistant, and I am not able to ...., but I will be doing ..... for you today."

    It would be most helpful if people would just come in and just describe their symptoms as opposed to saying, this is what I have and this is what I expect you to do to fix it. If that was how medicine was supposed to operate, there would be vending machines that could dispense prescriptions for the price of an office visit.
  11. by   mitchsmom
    I agree with your overall jist. At the same time I wonder, do you think that that kind of attitude in those pts can be turned into a postitive thing? I mean, if they are so interested then maybe they'll be compliant if given some more explanation as to exactly why the providers have determined that their dx isn't it. Like say, what makes you feel that you have Wierd Rare Syndrome X? Then maybe say "Ok I see how your symptoms match that, but we are able to rule out Wierd Rare Syndrome X because people with it all have three eyes and poop purple in addition to the symptoms you described, are you having those problems?". Now ask the IBS questions and tell them exactly why you think it's that, etc. I don't know, it just seems like those kind of people are information hounds and would respond well that way - I think they usually feel like they don't get enough information or that the doctor isn't listening to them fully. But I am not even in your shoes yet, I am just going by people that I know that are that like that. I am that way except I don't actually say what I'm thinking, or if I do I just say something like I was worried I might have "x," is that a possibility?
    I just think that alot of those people who "insist" on things need more information (like the abx people must not understand that it isn't going to help them when they have a cold, taking them when not needed leads to more problems with resistance, etc. etc).. when they are just flatly told "no" or not given info or explanation they just see it as resistance or the godlike medical attitude and then *they* get more of an attitude for next time, and so on until everyone is pissed. Some people just don't want to take your word for it - they need to know why, and I don't think that's a bad thing, I think misdiagnosis happens more than we'd like. Then these people develop a mistrust & get the attitude that "I can only trust myself". So they need more explanation & discussion of why things are the way they are. I'm sure I'll be the odd one out here, sorry Finally, I'm sure some are just nuts or hypochondriacs like my mom and there prolly ain't much you can do unless you want to become a therapist and work miracles!
    Last edit by mitchsmom on Apr 10, '04
  12. by   Gompers
    How about nurses diagnosing themselves? Because I did that, I have to admit. Was on heavy antibiotics for 4 weeks and suddenly developed the worst sore throat of my life. I didn't feel sick or congested at all - just like I was swallowing red hot knives! Went to the doc, told her I thought I had thrush. She laughed at me! Said I didn't have a single white patch in my mouth. I told her to look further, that I was SURE it was thrush (had another lovely yeast thing happening, so it was already taking over my body). She rolled her eyes, took another look WAAAAAAAY down my throat, and what do you think she saw? "That's the worst thrush I've EVER seen in 30 years!!!"
  13. by   kwagner_51
    GUILTY as CHARGED!!!

    I went to my dr. and told him I was allergic to tetanus shot. THAT was the ONLY thing I had done different. He tried to Dx it as TOENAIL fungus GRRRRRRRRRRRRR!!

    I had hives and was itching from my feet to my thighs. My feet and legs were swollen 3x their normal size.

    His solution? 120 Lortabs @ 7.5 mg each.[To be taken FOUR times a day PRN. I weigh 140 lbs and am 5'5" tall!! If I had taken them at that dosage level, I would have been addicted!! This was in Dec. 2002. I just counted them to see how many I have left. 95] Oh yah, and a fungal med, antihistime, prednosone, and who know what else.

    It took me 3 1/2 months to get over the reaction.That's how long the shot stayed in my system.

    I also self diagnosed my son. He woke me up in the middle of the night snoring. I heard him OVER my fan. He STOPPED breathing for over 20 seconds. I moved him so that he would start breathing again and 5 min. he did it again. He sleeps with his neck hyper-extended. Took him to my pcp and he referred us to an ENT specialist.

    Dx: He is 13 y/o and scheduled for a T & A on May 6. He also has a hearing loss. His ears are full of fluid and both auditory tubes are blocked!! He is on a 20 day course of atbx in hopes of curing the hearing problem.

    Sometimes parents KNOW what is wrong and need to steer the NP, Dr. in the right direction. Other times, they watch too much TV and listen to the ads.

    My 0.02 cents
  14. by   kat911
    I was told I had IBS by my GI doc, turned out it was bile acids s/p GB and med reaction to glucophage, worst diet I ever went on, lost 35 pounds. Sometimes the patients are right,don't stop listening, they may be right. Just 4 weeks ago told my MD I thought I had pneumonia, she said no just bronchitis. Four days later admitted with bilat pneumonia, spent 5 sleepless days in the hospital. Man that solumedrol is great stuff I was so high didn't sleep for first 30 hours. But I felt good!

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