Patients diagnosing themselves - page 2
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. ... Read More
Apr 11, '04Occupation: RN - College Health Specialty: Geriatrics/Oncology/Psych/College Health ; Joined: Jun '02; Posts: 6,584; Likes: 70Quote from mitchsmomHeeheehee! You tickled me .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?"
Absolutely - I am a big fan of always explaining why it is thought to be this dx versus weird rare syndrome x. (We seem to get the people who start in with, "Well, I see there's a little spot in the middle of my forehead which is no doubt the third eye emerging.")
I just wish people would allow us to rule out horses as the source of the hoofbeats before we go zebra hunting .
Apr 11, '04Occupation: Lactation consultant, L&D RN, some postpartum Specialty: OB, lactation ; Joined: Oct '03; Posts: 1,951; Likes: 95(We seem to get the people who start in with, "Well, I see there's a little spot in the middle of my forehead which is no doubt the third eye emerging.")Last edit by mitchsmom on Apr 11, '04
Apr 11, '04Occupation: Retired Specialty: 38 year(s) of experience in Women's health & post-partum ; From: OR, US ; Joined: Aug '02; Posts: 566; Likes: 176I often wonder how the various health care providers react to all the TV commercials urging people to "ask your doctor" about the drugs being advertised. Sometimes there isn't even a clue as to what you're supposed to be treating. Meanwhile, my HMO is now asking the docs to hustle you through in 15 minutes. That's probably about right for your chief complaint, but doesn't allow any time to discuss any other potential problems that you want to bring up. Am I going to make a special trip across town to ask my doctor what he thinks I should do about the fungus I THINK I'm getting on my left great toenail? Or even (and this is an actual problem) about the pain in my left knee which seems similar to a torn cartilage I had in my right knee 15 years ago? Okay, I hate going to the doctor and do tend to put it off for minor things as long as possible.
Apr 11, '04Occupation: RN - College Health Specialty: Geriatrics/Oncology/Psych/College Health ; Joined: Jun '02; Posts: 6,584; Likes: 70When we schedule appts, we set the amount of time based on the problem the patient reports he/she is having. When folks add on a lot of "while I'm here" issues once they arrive, we run into docs getting behind. It's absolutely not a problem on our end to say when you are making the appt, "I have several concerns." The appropriate amount of time can be allocated then. I'm not a big fan of going to the doctor, either, and I will make my little list if I have a couple of different problems - just make sure the person scheduling you knows you have more than one concern.
For instance, when someone wants an appointment for a flu/cold/cough type of concern, we allocate a pretty short amount of time. The only time I cringe is when the person arrives, has the specified concern addressed, and as their hand is on the doorknob to leave, says, "Oh yeah, and I've had this rash on my back for the past two years I wondered if you can look at while I'm here".
As far as the direct-to-consumer advertising goes, it's very frustrating. They neglect to mention things like "Allegra is rarely covered by insurance companies without a big fight and, while it is a very effective medicine, will cost you $80 month out of pocket." Any drug you see advertised all over the television is expensive. It has to be to make up for the fact that pharmaceutical companies spend more in marketing drugs than in researching new ones.
Apr 11, '04Occupation: Retired Specialty: 38 year(s) of experience in Women's health & post-partum ; From: OR, US ; Joined: Aug '02; Posts: 566; Likes: 176Thanks for the suggestion ("I have several concerns"). I'll try that the next time I call for an appt. if I do have several things I want to bring up. Actually, the last time I had a list of four things I wanted to discuss & Dr. L couldn't get to all of them
Apr 11, '04Occupation: ED Nurse Specialty: Burn/Trauma ED ; Joined: Apr '04; Posts: 56; Likes: 6Well, I'm sure it's annoying to have Pt's Dx themselves, but like you said, it's good to have Pt's who are actively involved in their care. As (another) example, last fall when I was taking A&P we discussed diabetes and it occurred to me that my mother had polyuria, polydipsia, polyphagia, and she was 55 and overweight w/ a Hx of hypertension.
The same week that I learned about diabetes she went for a checkup w/ her PCP. I asked her if he had ever mentioned anything about having blood tests done to check for diabetes. And he hadn't!!!
Of course once she did get some blood tests done (not sure what he had done as I didn't know about any of that stuff then), he gave her the dubious Dx of "pre-diabetic." That was in October, 2003. Since then she has lost 30 pounds, exercises 6 times a week for 2 hours each time, eats WAY healthier, etc, etc.
So, she goes back to the doc a couple weeks ago and based on a Hemoglobin A1c of 5.8 mg/dL he says she's diabetic! Without ANY blood glucose levels!!! I am terrified to think about the many people this guy is supposed to be treating! :angryfire
Oh, and also in August of 2003 she went to this guy for a regular checkup and her BP was 190/130. (She had decided not to take her BP meds for a couple months.) The guy just sent her home and told her to remember to take her meds!
So, sometimes the Pt (or her family) need to be actively aware and involved in their care.
Apr 11, '04Joined: Feb '03; Posts: 56I do agree with you.
Quote from Nurse RatchedI 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.