Did your doctor touch the area that hurts?
This is not medical advice.
I don’t want to exaggerate the occurrence of this problem, so I’ve been reflecting on it for a few weeks. I’m confident in saying that I see a wrong diagnosis by a doctor on a monthly basis. And if you’re thinking, who is this arrogant jerk to say such a thing, I will defend the doctor’s position near the end.
Case #1
A patient comes in with a diagnosis of hip bursitis. When we touched the bursa, it didn’t hurt. When we pushed really hard, just to make sure, it didn’t hurt. In the sum total of this persons’ history; they play golf, have poor, painful stooped over posture, weak hip muscles, weak core stabilization, and possibly piriformis tightness leading to some sciatica symptoms. All those issues can be addressed by strengthening, and some video feedback on posture.
If we had not touched the bursa ourselves, to rule it out, we might be wasting our time treating that specific issue. That’s an important distinction in the big picture of treating ailments.
When I do see someone with hip bursitis, I’m more interested in the origin of that problem. Focusing on how this started, will help us better fix the problem, and prevent it from coming back by addressing the original deficits.
If we focus on the bursa alone, we are just putting a very expensive medical industry band aide on the problem.
Case #2
A patient comes in who had fallen very hard on a concrete floor. Feet out from under them, full on tailbone. Hurts even thinking about it. Patient has to follow Worker’s Compensation rules, based on doctor’s diagnosis. Doctor does not touch or look at patient’s tailbone. Looks at x-rays, and says they’re fine, and can go back to work 8 hours per day.
We look at the tailbone and palpate a humongous hematoma that is extremely painful. Pt is not tolerating 8 hours of work.
The Brainwashing Narrative
In the first case above, we tactfully explained to the patient that we may have found some different or additional problems. They respond with, “well, I would never self diagnose myself, but it did seem odd that I don’t hurt there…”
And therein lies the problem. The industry has belittled people for searching things on the internet. But that presumption is that we must always trust our doctor. Have any of you heard of a misdiagnosis?
Yes, we do want the doctor’s professional medical opinion (they’re called opinions, not facts). But it’s also ok to understand your own situation, and protect yourself.
Nurse practitioners aren’t as good….right?
My son sprained his ankle in football multiple times, and we could get in to see our NP weeks before the specialist. I’ve been treating his ankle, but we also need an unbiased opinion, and the school won’t recognize “Dad’s” opinion, understandably so.
She has him take off his shoes and socks, and does a very thorough physical examination. She takes her time to present an extensive plan of care, and calls us to follow up 3 days later.
There is a narrative floating around Medicare circles, that they are going to pay NPs less, because they’re not as good as doctors. And by good, they probably mean “educated.”
In my experience, NPs tend to be female, and are better listeners of history, and at times, a better quality of medical care. Just my impression of averages, and not that way all the time.
The main problem
Stop being shamed into thinking that you are not allowed to understand your own anatomy, condition or options. I’ve witnessed many many mistakes in my career that have harmed patients. Protect yourself. Don’t argue or be dismissive of the doctor’s opinion either. Listen to their opinion without interrupting. Be cordial and professional. But reserve the right to seek alternative opinions.
Defending the doctors’ position
Maybe some of these things are going on…
You were late to your appointment.
You wanted to talk about your dog’s cute personality for 10 minutes first.
You keep interrupting the doctor.
You insisted on being seen “sooner”, but also want 30 minutes of their undivided attention. You can’t have it both ways.
You dismiss every suggestion.
You tell the doctor that your niece is going to medical school, and she said ___________ is why you’re in pain.
You trust/don’t trust anything the CDC says…
And many more. Please add yours in the comments section.
This is just more ammunition for learning about your own condition and options. More importantly, do something about it.
Prevention is worth far more than the cure to you.
The industry makes 10 times the amount of money on the attempted cure.
Awesome Mike!! That’s all I need to say. Keep putting it out there!!! And… thanks 😊