How Doctors Think

If you understand how doctors think about illness and pain you will be better equipped to use them to your benefit. In general, doctors are trained to gather information from which to draw a conclusion that guides an action. The information a doctor gathers may include answers to questions about symptoms, general health, medication/drug use, past health, ability to function, family history, diet and other factors that might help identify the nature of a problem. In medicine this is called taking a history. This information guides what needs to be physically examined in the patient to obtain more useful information.

After this, there is usually enough information to draw several possible conclusions (i.e. diagnoses) or even a firm conclusion. The possible conclusion(s) will then guide the action of choosing tests. Tests might confirm a diagnosis and/or rule out several possible diagnoses. Tests may not be necessary in some cases and the initial conclusion may lead to the action of starting treatment. Tests are simply another method of gathering information to which the doctor must apply knowledge and reason in order to draw a conclusion. The conclusion or diagnosis guides treatment.

It can’t be emphasized enough that the process above describes a model of reasoning that is used to at least some degree in all medical decision making, regardless of specialty. Taking a history is still the single most important method of gathering information for doctors in clinical practice. The history is the basis for the direction of further information gathering (e.g. specific tests) and decision making.

Therefore, if you want to get the most out of an encounter with a doctor you must be prepared to provide information that may be crucial with respect to diagnosis and treatment. If you can’t or won’t try to provide an accurate description of your pain, your past history, treatments you’ve tried and medications you take, then your doctor may not have the information necessary to draw any useful conclusion. This can lead to too many tests, referrals or even inappropriate treatment.

Despite amazing high-tech tools such as MRI scans, these have not been able to replace a good medical history as a guide to choosing treatment. Medical technology is still a supplement, not a replacement for caring for patients. When you are in the doctor’s office, remember how doctors think and help them with their information gathering. Your role in using doctors well is more important than you may have thought.

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