April 9, 2011

One of my favorite things for a patient to say to me is, “I’m not a doctor, but I think I have . . .”   Patient’s insight is one of the most valuable tools a doctor has when it comes to diagnosing any illness.  While my patients don’t have M.D. degrees, they know their bodies better than anyone else in the world.  In medical school, one of my best professors taught me that 95% of diagnosis was asking the right questions and listening to the patient’s answers.  He was right! 

The patient who starts the conversation with, “I’m not a doc” has already asked himself many of the questions I usually ask, has already analyzed how he is felling, has gone to the internet looking for a diagnosis and has drawn his conclusions.  In short, he has completed, at least, the preliminary part of my exam, if not the whole thing.  There is actually a 50/50 chance he has gotten it right; and, if he hasn’t, he has usually narrowed my differential diagnosis considerably.  In short, he has made my job easier by taking on the role of Watson to my Sherlock Holmes.

My response to “I’m not a doctor” is to encourage my patient to explain why he believes what he believes.  Some of my most brilliant diagnosis have been made by believing what my patient told me, even when it sounded impossible.  One thing 30 years in practice has taught me is that everything is possible.

My very best lay doctors are mothers.  When mothers tell me “I’m not a doctor but”, they are right 80% of the time and very close to right the other 20%.  Mother’s intuition (gut feeling) is not guess work!  Mothers’ intuition is knowledge based on the special relationship they have with their children and some form of magic I don’t understand!

A new baby was born to my practice this week.  I took care of her mother when she was born.  As a family physician, there is nothing more precious than a second generation child!  I spend a great deal of time counseling new moms on the care of their newborn child.  The most important lesson I teach them is to listen to their gut feelings and act as if they are real.  I teach them to inform me when their gut feelings tell them something is wrong, even when they think they are being foolish.  I teach new dads to listen to their wives.  I tell them they have magic that we, dads never will have nor understand.  (I know that somewhere in the male handbook it says there are penalties for listening to our wives; but, when it comes to our children’s health, an exception must be made.)

The team approach to medical care includes the doctor, his staff, the patient and their family and loved ones.  By working together closely, we can accomplish almost anything.  Feel free to play doctor when it comes to exploring yourself and your problems.  Feel free to share your thoughts with everyone on the team.  When it comes to treatment, please consult with me first.  The life you save may be your own.