Certain conditions can be difficult to diagnose, especially with patients having to self-report pain and fatigue, and blood tests often returning a “normal result”.
People can find themselves going from one doctor to the next, with no result, no diagnosis, just inconclusive tests and a feeling of hopelessness.
Doctors can often become disinterested with a chronic set of symptoms that are hard to pin down onto one condition versus many other similar conditions. Some become dismissive or weary as they are too overworked to dedicate extra time to catching up on new studies and research various conditions that might be implicated with a patient’s set of symptoms.
Many doctors will have knowledge gaps with certain conditions, which might have only had breakthroughs in understanding in recent years. This knowledge won’t have been included in their medical education decades ago, and whilst they are required to keep up with current major medical knowledge and advise, they can’t possibly keep up with everything. It can take many years for the results of new studies to be properly scrutinized and that information to be disseminated to the wider population of medical practitioners.
So how can you help your own diagnosis, and how can you help improve your doctor visits?
The most important advice is to prepare before you go. Often doctors visits can be short, or you might forget something important, especially if you are dealing with multiple symptoms. Due to the state of healthcare, it’s a common situation that you only have time to go over one symptom, so although it’s best to at least communicate your worst symptoms over your minor ones, you should start by mentioning everything you’re currently dealing with in a concise manner. Write down a short set of bullet-point notes about your concerns, current symptoms and any questions.
Being concise to begin with is of utmost importance. One mistake is to go into the appointment and immediately start into a long disconnected speech about all your medical issues. Instead, start with a short overview of your current situation.
Doctor : Hi, how can I help you today?
Patient : Hi. Well, I’m struggling to manage my daily pain and fatigue. I’m also experiencing increased anxiety and sleep disturbance. I’m concerned about the effects on both my work and home life. The worst symptom recently is increased pain when I walk.
From here, a doctor might go in various directions because this is quite a fully loaded initial statement, but will likely pick up on the last thing you say. It’s best to let a doctor ask as many questions as they want, and provide detailed answers which are as short as you can make them. If they start to focus on something you feel is minor, redirect them to your major worry if that hasn’t been addressed. Also try to be specific because the doctor will likely just re-question you to get specifics.
In a more ideal visit, you just have one problem i.e “Hi, I have really bad sleep disturbance lately. I’m finding it very hard to fall asleep”, but chronic illness can have comorbidities and multiple symptoms feeding into each other, it’s important to give the full picture. Don’t be tempted to either minimize or exaggerate anything.
If you feel like you never really get answers from doctor visits, you can try to at least ask towards the end of an appointment, what their initial or current assessment is. Many doctors don’t like to give out any initial thoughts as they wait for test results instead, but it can be helpful to you to know where their current reasoning is. Make it clear you aren’t expecting an immediate diagnosis, but feel like you need some direction in your understanding of what’s going on with your medical health.
It’s also important to remember you can say “no” to a doctor’s recommendation, you don’t have to try certain medication when you have reservations about it, you don’t have to be referred to a certain specialist when you feel like a different one might be more useful.
Both patients and doctors can very much feel like patients require an immediate answer or prescription. This is the wrong mentality to have, the most important thing is to have the medical professional understand your symptoms accurately and for them to then communicate your options accurately.
If you find your symptoms are dismissed by a doctor, don’t be afraid to switch doctors when you make a follow-up appointment. There’s no point sticking with a doctor who you feel isn’t taking you seriously. Doctors aren’t perfect and many symptoms presentations indicating a condition can elude them, they are human after all.
It’s a depressing thought but consider that you might have to go through 5 or even more than 10 doctors/specialists before you find one that connects the dots to your condition. It can be a difficult journey to say the least.
But no matter your own thoughts on your condition, you have to try to seek a medical expert’s opinion, you can’t rely on self-diagnosis, and reading through “could be’s” online or in books.
Remember to plan what you are going to say in your appointment, be precise and logical when you communicate your problems, keep your expectations for an immediate answer or treatment low and to properly consider your options for treatment or further diagnosis going forward.
Thought-provoking article. How can patients approach doctors about alternative treatment options?