Tuesday, 8 October 2013

The Good, The Bad or The Common? Help your doctor help you

I have found during my training as a doctor that medicine is just as much an art as it is a science. Few things are absolute or 100%. New studies come out daily, which change the way we practice. Different countries, even provinces may follow different guidelines. It is not that one is necessarily wrong, or the other is right… it is just different.

When patients go to the doctor, say for a headache, doctors are trained to formulate a differential diagnosis. Most of the time we cannot guarantee 100% what is going on. Investigations may need to be done, and follow up appointments made. Treatments may be attempted, stopped and then reassessed many times. When formulating a list of possible diagnoses, most physicians include things that are common and things that are life threatening (even though it may be unlikely). Next time you go to the doctor with an issue, say abdominal pain, here is a little mnemonic to help the visit go smoothly. Being less vague about a complaint will help the doctor arrive at a diagnosis, which in turn will get you the appropriate treatment faster. There are a lot of different ones to use, but this one is relatively easy to remember - OPQRST.
Say you are going to your doctor for abdominal pain:

O – onset
             -When did the pain start? What were you doing? Was it sudden/gradual onset?
P-provocation and palliation 
            -Does anything make it better or worse?
Q- quality
           -What does it feel like (sharp, dull, constant, intermittent). Any other symptoms?
R – region and radiation
           -Where is the pain? Localized or everywhere? Does it radiate anywhere?
S- severity
           -How bad is the pain? Some doctors use a scale - 0 (not bad) to 10(worst pain of your   life). 
T – timing
            - How long has the pain been going on? Has it changed? Have you ever had this pain before?

Hope this helps with your next visit to the doctor! 
Diagnosing a classmate in the early days of training :)

1 comment :

  1. hi linds and carolyn -- love the med info-- but can you please include more info regarding coping with broken bones -- thanks so much -- wendy