Yesterday I shared with you the first of a series based on an article in Public Health Newswire where Carolyn Clancy, MD and director of AHRQ answered questions for the community centered around the consumer in health care. What I may not have mentioned yesterday is that some of the answers to the questions inherently involve technology such as internet education, medical device electronic reporting & monitoring and basic access to technologies in everyday use.
The second question asked of Dr. Clancy was:
Q: You spoke at a health literacy conference in September where you said that 75 percent of medical diagnoses are based “on the story, never mind the tests.” What did you mean by that, and why is it so?
Clancy’s response of “There are a number of studies that confirm that history – the patient’s story – is the most important factor in accurate diagnosis 75 to 80 percent of the time” is one that I agree with whole heartedly. Tests tell facts. Facts make up a scientific picture. And anyone who watches Bones on TV knows that these do not make up the whole of the problem that a patient may present with! Family and social histories play a major role in our health. Genetically we may have probable conditions that will “pop up” as we age – such as my predisposition for familial tremors. I have friends that have been tested for the probability of breast cancer and thus chose to have mastectomy as a preventative measure. These are not easy decisions to make or deal with.
What I am leading to is the reason, the compelling need, for patients to communicate with their clinicians (again it is not only physicians that we as patients talk to) their stories outside of “my stomach has been hurting me” or such symptoms. In turn, the clinicians have a responsibility to pay attention to the stories, listen, and ask questions that may lead to more pertinent information. When we get back to the compassion and humanity in health care we will be much more able to treat the patient as a whole – not as a reactive symptom presenter. And just FYI to the clinicians – making me feel guilty about tests that I haven’t had done and need to is not going to make me run out and do them. Maybe you should ask me why I am resistant? Then you can help me deal with that part of the issue.
What has/have your experience(s) been in communicating with your clinician(s)?