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Wednesday, March 15, 2017

Doctor reveals: 7 mistakes patients make during a visit

I wouldn't classify these as 'mistakes' per-say. I would say that the patient has the answer to their problem-the doctor just has to listen for it. How quickly you convey that problem depends on communication style-some patient convey a given problem in 5 minutes while another may take 45 minutes to convey a similar problem. It also depends on how the doctor problem solves-does she build the big picture from details to big picture or only focuses upon details if the big picture doesn't make sense (I.e., build the tree from many leaves or looks at the tree and focuses on where there is a missing branch). Both ways are correct and effective. There is an element of recall and revision bias in medical history telling-one fine tunes the story the more times it's told and after opportunity to reflect upon one's own responses (the doctor asked me if I ever experienced 'x' and I said no, but on reflection I did have 'x' 6 months ago when this all started; I just forgot). Sometimes the story is told and solved in minutes and sometimes it takes years because the story is being written as you live and a few more words are needed for the doctor to solve the problem. Because the body only has limited ways to express an issue, more likely than not, the answer to your questions may be 'it depends'. For instance, some symptoms for heat failure, COPD, asthma, kidney failure, pulmonary hypertension and being deconditioned/unfit are nearly identical. The body is interconnected. What does night time urination or esophageal reflux or an enlarged heart have to do with sleep apnea? Not related or related? They are related. As a doctor, I have realized that the more I know, the more I don't know. After five board certifications, I can say that definitive answers are likely to be given by those who don't know enough.
from Rajesh Harrykissoon, MD

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