You want the medical truth? You may not be able to handle it, but here goes. More times than you might imagine, your doctor is racked with uncertainty about what’s wrong with you.
“Anyone with anything can walk through the door at any time,” writes family doctor Benjamin Brewer in his latest WSJ.com column on the art and science of diagnosis. “We have to figure out what to do in just a few minutes, often with scant resources.”
Your doctor is probably doing his or her best, but the fact is that your problems don’t always fit what’s in the medical textbooks. “The uncertainty that hangs over many cases seems strange to patients who expect doctors to come up with the one true answer and cure on the spot,” he writes. But it’s often tough or even impossible for your doctor to do that.
Sometime the clues to what ails you don’t add up. But Brewer also worries that the art of diagnosis is in decline, abetted by many doctors’ overuse of fancy lab tests and scans. “Tests like those can be a crutch,” he writes. “In my experience, they don’t always help with diagnosis as much as a thorough medical history or physical exam.”
Don’t look for improvement anytime soon. As the old guard retires, there are fewer “master diagnosticians” who skillfully take medical histories and perform hands-on exams, Brewer writes. “The rest of us all think we’re above average. That’s one diagnosis we’re pretty certain about.”
Analyze This: Talk about the state of diagnosis with Brewer in his online forum.
