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Tuesday, 30 December 2008

Who knows better? Doctor or patient?



Who knows better? Doctor or patient?
Sometimes, you as a doctor have an opinion and decision regarding a diagnosis and plan of management that is not matched with the patient mind.
Cartoon:
· Patient is telling doctor that he is critically ill and cyanosed.
· By the way, the monitor shows his O2 saturation is zero and BP is zero over one!
· Doctor insists that patient is OK and tells: you will not know better than doctors will.
For example, one case of atypical chest pain in a middle aged female. Her first ECG was normal first set of enzymes was normal. She received NSAIs in vain. The internist in ER decided not to discharge here, as doctor believed that patient is always true. In addition, put her as C.P. for Investigation. Then, Patient has AMI and managed in CCU. If this doctor did not believe in-patient and said doctor knows better, patient might be missed.
NB: This is the matter of our post this week.
If you have any experience regarding this argument, tell us.
********************


11 comments:

Dr Ibrahim samaha said...

but many of patients are psychic ...
But doctor should do every thing to exclude organic causes..

Doctor, my ECG show elevated T wave
& Ihave normal lipid profile...
what this indicate for?

aydy said...

عندما يذهب المريض الي الطبيبة و الذي بدوره يسأله - من ماذا تشكو- يرد الكريض ولماذا اتيت اليك إذن الست الطبيب الذي يعرف كل شيئ --- تحياتي

Sonnet said...

You? or one of your patient

Sonnet said...

if so you can do echo and tell the detailed lab profile to know your risk exactly. it may be just a normal T wave variation.

Dr Ibrahim samaha said...

لا انا
والايكو نورمال
ولما روحت لدكتور قالى دى
نيروزس
بس مش عارف

ساعات لما ببقى مواقف ضغط وعصبى كتفى الشمال بيوجعنى
وبخاف جدا من الامراض وكده

jancy said...

Though fear of an impending attack does simulate a real one symptomatically, investigations and reports shpuld be there to alleviate the patients' anxiety.

obamacenter said...

confuse to choose, patient or doctor...???

Smile to your blog... :) :)

Sonnet said...

OBAMA CENTRE
THANKS FOR YOUR SMILE
I VISITED YOUR BLOGS
SO NICE

Sonnet said...

Jancy
welcome
thanks for your comment

سـهـيـر زكــي said...

صباح الخير

دي أول مرة بزور فيها المدونة وانشاءالله متكونش الاخيرة

مش حسأل أي سؤال أو حتى أشارك دلوقتي, بس كنت عاوزة أعرف لو الكتابة بالعربي ممكنة والا لأ, قصدي ممكن مشاركاتي تكون بالعربي, مع شوية انجليزي لما حكتب المصطلحات الطبية مثلا؟

عادي؟

يارب يكون جوابك يادكتور بالايجاب, اصل انا مع اني بعرف اكتب بالانجليزي, لكن التعبير يكون عندي اسهل لما بكتب بالعربي

ممكن اكتب بالفصحى لو حبيت

ميرسي

Sonnet said...

اهلا بك سهير
دائما
يمكنك التعليق كما تحبين