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Making Sure You Have The Right Diagnosis: Tips From An Internet-Savvy Patient

People generally have a sense there might be information on the Web that can help them when they are worried about their health. They also have a sense there is a LOT of information and some of it may be wrong. All of that is true. What is a strategy to find the good and avoid the bad?

This morning, I chatted with Mike Collins, host of “Charlotte Talks” on WFAE, public radio in Charlotte, North Carolina about The Web-Savvy Patient and some of my “Insider Tips” within. We talked at length about how you can get started looking for health information on the Web.

First of all, if you’re worried about your health, make sure you get an accurate diagnosis, and make sure that diagnosis is specific to you. Don’t be satisfied if your health care team tells you that you have a “thyroid problem.” Find out if it is hyperthyroidism or hypothryroidism. It makes a big difference. If you don’t know what you have you will find yourself wandering all over the Internet, discovering information that won’t be right for you. You might be lead to believe that you have a brain tumor, rather than a migraine induced by monthly hormones or the effects of too much coffee (we know that one here in Seattle!). So rule #1 is know the details of your diagnosis and if you don’t feel confident, recognizing some people are misdiagnosed, get a second opinion to confirm it. Then, and only then, should you start your search online. Read more »

*This blog post was originally published at Andrew's Blog*

How Good Is Your Doctor At Diagnosing You?

We’ve all been there. It often starts with some kind of recurring pain or dull ache. We don’t know what’s causing the pain or ache. During the light of day we tell ourselves that it’s nothing. But at 3:00am when the pain wakes you, worry sets in: “Maybe I have cancer or heart disease or some other life-ending ailment.” The next day you make an appointment to see your doctor.

So now you’re sitting in the exam room explaining this scenario to your doctor. Based on your previous experience, what’s the first thing your doctor would do?

A. Order a battery of tests and schedule a follow-up appointment.

B. Put you in a patient gown and conduct a thorough physical examination, including asking you detailed questions about your complaint before ordering any tests.

If you answered “A,” you have a lot of company. A recent post by Robert Centor, M.D., reminded me of yet another disturbing trend in the doctor-patient interaction. The post, entitled “Many doctors order tests rather than do a history and physical,” talks about how physicians today rely more on technology for diagnosing patients than their own “hands-on” diagnostic skills — a good patient history and physical exam, for example.

Prior to the technology revolution in medicine over the last 20 years, physician training taught doctors how to diagnose patients using with a comprehensive history and physical exam. More physicians today are practicing “test-centered medicine rather than patient-centered medicine.” Medical schools focus on teaching doctors to “click as many buttons on the computer order set as we possibly can in order to cover every life-threatening diagnosis.” The problem is that medicine is still an imperfect science, and technology is not a good substitute for an experienced, hands-on diagnostician. Read more »

*This blog post was originally published at Mind The Gap*

“Simple Blood Test” For Cancer: Breakthrough Or Nightmare?

That’s the question Dartmouth’s Dr. Gil Welch asks in a column on the CNN website. He reflects on [recent] news about a test in development that might find a single cancer cell among a billion healthy ones — as so many news stories framed it. Welch analyzes:

“But it’s not that simple. The test could just as easily start a cancer epidemic.

Most assume there are no downsides to looking for things to be wrong. But the truth is that early diagnosis is a double-edged sword. While it has the potential to help some, it always has a hidden side-effect: overdiagnosis, the detection of abnormalities that are not destined to ever bother people in their lifetime.

Becoming a patient unnecessarily has real human costs. There’s the anxiety of being told you are somehow not healthy. There’s the problem that getting a diagnosis may affect your ability to get health insurance. There are the headaches of renewing prescriptions, scheduling appointments and keeping them. Finally, there are the physical harms of treatments that cannot help (because there is nothing to fix): drug side-effects, surgical complications and even death. Not to mention it can bankrupt you.

Americans don’t need more diagnoses, they need the right diagnoses.

I don’t know whether this test will help some patients. It might, but it will take years to figure that out. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

How To Help Your Doctor Make A Good Diagnosis

When patients and doctors communicate effectively, the patient has the best result. Not every doctor asks the critical question that can cinch a diagnosis. Yet good communication, coupled with good diagnostic skill can be worth more than $10,000 in tests and referrals to consultants.

You can help your doctor figure out what is going on by thinking and communicating like a physician. Whether you have a new problem or something that has been bothering you for a long time, here are some things that the doctor will want to know:

1. What are the symptoms? Be specific. Don’t just say “Sometimes I have a pain in my stomach.” Since more than 80 percent of health problems can be diagnosed based on information that you provide, make sure you can verbalize what you are feeling. Is it crampy? Does the pain come and go? Where is it located? Is it sharp or more like an ache? These specifics are giving information that your doctor can use as she thinks of the anatomy, physiology and causes of pain.

2. How long has it been going on? Try to be specific. ”Awhile” doesn’t mean anything to a doctor. That could be two days or two years. Did it come on gradually or suddenly? There is a different cause for any symptom that is chronic (over several weeks) vs. sudden or acute. Did anything precede the symptoms? Travel, trauma, or life stress can point to different causes. Read more »

*This blog post was originally published at EverythingHealth*

How To Talk To Your Doctor: 3 Simple Steps

As a practicing primary care doctor, I continue to work incredibly hard on making my bedside manner even better so that patients feel heard. The other reason is because as most doctors learned in medical school 90 percent of getting the right diagnosis comes from taking a good history from a patient.

Unfortunately with shorter doctor office visits and doctors interrupting patients within 23 seconds of starting, you need to know how to get your concerns across. While I don’t believe this is the responsibility of patients, the reality is not everyone has access to doctors with great bedside manner.

How to talk to your doctor is quite easy if you follow three simple steps. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

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