Diagnosis is the foundation on which all care and treatments rest.  If the diagnosis is wrong, most probably so is the treatment.  Diagnosing an illness is an art.  A diagnostician needs to be one part scholar, one part detective, and four parts artist.  He has to be a good listener, open minded, and capable of assimilating a large amount of sometimes confusing data into an accurate picture of a disease process.  A diagnostician must also be humble, capable of seeking help and counsel from multiple sources.

A diagnostician’s most valuable tool is a reliable patient.  Just as Sherlock Holmes needed Dr. Watson, the most brilliant diagnostician needs a sidekick, his patient and partner.  When I went to medical school 35 years ago, I was taught that 95% of diagnosis comes from listening to the patient and gathering a good history.  Not only was my teacher brilliant, but if you listen to your patient long enough, most patients will lead you to a proper diagnosis.  In, “I’m Not a Doc, But …” I reviewed the importance of encouraging your patient to play doctor.

Modern medicine offers a host of diagnostic tools designed to help the physician in his diagnostic process.  CTs, MRIs, lab tests, and a host of other diagnostic tests are often employed in figuring out what the cause(s) of a patient’s illness is (are).  Unfortunately, both patients and physicians have become all too dependent on these modern marvels.

When there is no clear diagnosis, your doc will formulate a “differential diagnosis,” a list of all the possible causes for what ails you and formulate a plan to help treat you.  Be a great sidekick/partner.  Work hard to be accurate in your description of your symptoms and the historical facts surrounding your illness.   The life you save may be your own.

Stewart Segal is a family physician who blogs at Livewellthy.org.

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