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Making the Diagnosis


The Diagnosis

After the doctor has spoken to you and examined you, then he has to make a diagnosis. A diagnosis is just telling you what’s wrong with you. He can do this with or without the help of other tests. Generally, the more experienced a doctor is, the fewer tests he has to do before he makes a diagnosis. A lot of patients leave the doctor’s office without a diagnosis, but this is not necessary.{{more}} You should have a diagnosis that makes sense! Most patients, especially the older ones, are reluctant to question their doctors, but fortunately the younger generation is changing that. With the advent of the Internet, more and more patients get information and are questioning their doctors. Some question before they leave the office (they come with what they think is the diagnosis) and some after (they go home and search the Internet and come back to the office with questions). Your doctor should be prepared to answer your questions. Your doctor should explain your diagnosis simply. The explanation should try to “tie in” all your symptoms, or if not, your doctor should inform you that the various symptoms are not related. This is rare, as most symptoms are due to the disease process that you presented with. Your doctor should be honest enough to let you know that he or she does not know exactly what is wrong with you, but after a few tests he should be able to tell you.

This explains why your tests should be done after the doctor has seen and examined you. Some patients meet me in the road and say things like “Doc, I am coming to see you because I want to get an X-ray form written”; in such a case, this person does not need to see me, as I am not an X-ray writing technician or, for that matter, a blood test writing or a prescription writing technician, depending on your needs. Such patients who already know their diagnosis should be able to do their blood test or get their medications “over the counter” without the help of a doctor.

Some patients explain this need by saying the last doctor whom they saw gave them a specific medication and blood test, so they assume the same thing is happening again. Still others get their blood tests done before they see you, only to realize after a proper history and examination that a different disease process is taking place and they have “wasted” their money getting irrelevant blood tests done.

Your doctor does not always have to do a test or give you a prescription. However, sometimes your doctor will request tests, also called investigations, to help with the diagnosis. In this case, the investigations are being ordered to help make the diagnosis, but your doctor usually has an idea of the diagnosis before the tests are ordered. Sometimes, the doctor already knows the diagnosis, but the test is done to confirm the diagnosis, as some tests are more “objective” than your doctor’s thoughts. In other words, you can measure and see tests results, but you cannot measure or see a doctor’s thoughts. That being said, an experienced doctor’s diagnosis is usually more accurate than blood tests or x-rays.

However, patients also feel more secure “seeing” a test and having a test being done and some will go from doctor to doctor requesting test after test, trying to “prove” that there is something “wrong” with them, even when their doctor tells them there is no test that can diagnose their disease. Investigations are also used to exclude another disease process that might look similar to the one the doctor is thinking of. These are called differential diagnoses. Investigations are also done to tell us more information about the disease process, like how “bad” the disease process is; e.g. is the process mild, moderate or severe? This can help us to decide whether you need to be hospitalized or not. Investigations are also done to inform us of complications of the disease; e.g. if it is a cancer, has it spread and if so, how far? For patients who need to be hospitalized for surgery, investigations help with preparations for surgery.

For comments or question contact:
Dr. Rohan Deshong
Tel: (784) 456-2785
email:[email protected]