What Can Patients Do if Their Doctors cannot Make a Diagnosis?

26.04.2018

The importance of never giving up if there are medical problems and an answer is not easily found. Examples are given.

I am always amazed when a patient tells me their doctors, after ordering  multiple tests, throw up their hands and say they don't have an answer.  If there is a real problem, such as a major weight loss, bleeding from the bladder or bowel, an answer has to be there if the right tests are done or if the doctors have done a thorough examination.

One of the most important things I learned as a pediatric resident from a wonderful chief resident, was you must always repeat tests, ask for a second opinion, and don't give up until you have an answer. This rule has helped me numerous times. If a chest X-ray is negative and there are respiratory symptoms or marked weight loss, a repeat chest X-ray should be done in two or three days. Sometimes tests are not accurate or the radiologist reading the X-ray may have missed something and a second X-ray read by another doctor may give an answer.

Simple practical things, such as repeating a urinalysis or urine culture have paid off for my patients many times. I had one teenager who was not feeling well, but had a normal  examination, blood count, and urinalysis. I wasn't happy about her and asked the mother to bring her back the  next day. There were still no obvious physical findings and for some reason I asked the girl to give me another urine specimen. "But you did one yesterday", her mother said. "Yes", I said,  but I want  another one and won't charge you for it". When the teenager handed me the urine specimen, it was dark brown. The diagnosis was glomerulonephritis, This is a dangerous diagnosis if left untreated. The mother never objected to anything else I ever did and her daughter responded well to treatment and grew up to be a lovely young woman. So a doctor should not give up until a diagnosis is found.

Article last time updated on 26.04.2018.

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