A Patient’s Chief Complaint is Rarely the Problem

Melanie: I hear so many stories from friends about struggling to get appointments with doctors, and waiting for hours to be seen in the clinic or hospital, only to experience an unfulfilling and rushed visit that doesn’t meet their needs. (Getting slapped with a surprise bill later on for services that weren’t covered by insurance adds insult to injury.) I’m always left with the same question: how do doctors know what’s bothering a patient without careful histories or adequate physical exams?

Grandpa: They focus on the so-called chief complaint. In other words, the patient’s brief answer to the first question, “What is bothering you?” often dictates the entire course of a doctor’s actions—from ordering tests and interventions, choosing the specialists to be consulted, deciding which drugs to be prescribed, recommending operations, and even prognosticating about outcomes.

Melanie: I was saying that doctors should cover all of their bases and give patients the time of day. But shouldn’t doctors also trust patients to tell them what’s wrong? Don’t patients know which part of their body is hurting, or if something isn’t normal? Why wouldn’t a doctor naturally follow-up on that basis?

A Patient’s Examination: Making Sense of the Health Care Debate

Today, everyone seems concerned about their health. My grandfather likes to quote Norman Cousins who said, “Most people think they are going to live forever until they develop a cold, when they think they are going to die within the hour.” That’s me! We certainly seem to be more health conscious than ever before in history, due in part to the Internet and 24-7 health news. (Killer mosquitos, hospital superbugs and disease-resistant antibiotics make me long for a bubble.) These days especially, health care has become a political football. Will ObamaCare save us? I have no idea.

To start an “intergenerational conversation,” according to the purpose of our blog—and for my grandfather to take me seriously—I needed a quick download about the crisis. Here’s what I found in a nutshell: