New, sophisticated and innovative tests and high tech equipment are now available to help physicians make a diagnosis. Computers also play an important role in providing information to the doctor that may be key in determining what is ailing a patient.
Unfortunately, because of all of these advances, sometimes lost in the quest for a diagnosis is the time-honored, basic means of making a diagnosis -- listening to the patient.
Some of the best diagnoses I have made were made because I listened to what the patient was telling me. It was that information that led me to the correct diagnosis.
Although the importance of listening to the patient is no new revelation, it appears that less time is being devoted to it. Listening requires time, something many doctors do not have today. In some practices, for a variety of reasons, the numbers of patients seen are important. Also, the manner in which computers are used by some physicians when seeing a patient has the potential of limiting discussion between doctor and patient. Some patients believe that the doctor pays more attention, and eye contact, to the computer than to the patient.
One hospital, sensitive to the possibility that the computer may become more important than the patient, has prohibited the use of computers in the examining room. There is no question, when used properly, computers are helpful in making medical diagnoses. I could not practice up-to-date medicine without a computer because so much information is now available it is impossible to remember, or even be aware of all of it.
However, it is still the findings culled from the history and physical examinations that remain the mainstay of leading the patient’s physician to the correct diagnosis. That means going back to the basics, taking the time to listen to the patient and doing a thorough history and physical examination. After gathering all of this essential information, then new high-tech studies can be used more effectively and efficiently.
Talking and listening to a patient has benefits other than just making a diagnosis, such as doctors learning about their patients as individuals.
For any relationship to be successful, communication is essential and that includes listening. This also hold true for the patient-doctor relationship.
Dr. Murray Feingold is the physician in chief of The Feingold Center for Children, medical editor of WBZ-TV and WBZ radio, and president of the Genesis Fund. The Genesis Fund is a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.