What do you do if a physician is unable to diagnose a patient's symptoms?

I'm a huge fan of Dr. Profeta, agree with his perspectives, and have a profound respect for most docs. However, as a two-time, stage 4 cancer survivor and neuropsychologist, I can't tell you how often my N of 1 trumped a doctor's "N of 1000." I also can't tell you how frequently I (and my patients) have been medically "gaslighted" by MDs. MDs typically have to give up so much of their personal lives to medicine and are so overworked that this leads to many bad outcomes, for them and us. Simply put: they can't keep up given that American healthcare is collapsing. One of the worst maxims that docs are taught: "If you hear hooves, don't think Zebra's." No, gifted docs consider horses, zebras, etc. simultaneously. Thanks for all you Dr. Profeta

??Accurate and timely diagnosis is pivotal to effective patient care. While experienced physicians often possess the acumen to rapidly discern disease processes and formulate treatment plans, comprehensive patient evaluation remains indispensable. Open dialogue between physician and patient, characterized by mutual inquiry and clarification, fosters trust, enhances understanding, and ultimately optimizes treatment outcomes. ??This collaborative approach not only expedites recovery but also empowers patients to actively participate in their healthcare journey. ??

This question made me laugh, because all I could think about was House MD (the TV show) and all the crazy tests and hoops people jump through in an attempt to diagnose a patient (it always is lupus!) , when at the end of the day, there is always a small group of patients that will never have their symptoms explained by conventional medicine. In those instances, understanding, empathy and honesty with the patient is key in helping them walk through their health journey --> For example, ME/CFS is the classic poorly misunderstood condition because clinicians stay so tunnel visioned in their lane and set of tests they can order. Often times, listening is key

?While experienced physicians possess a deep understanding of disease processes and treatment modalities, effective patient care necessitates a holistic approach. ?Open communication and shared decision-making between physician and patient are paramount in establishing trust, managing expectations, and optimizing treatment outcomes. ?This collaborative partnership empowers patients to actively participate in their healthcare journey and contributes to improved patient satisfaction.

Some diagnosis and symptoms are difficult to put together and can be challenging. Multiple factors can contribute to it - lack of transparency in communication bidirectionally, and not enough time to learn each other, patient and physician -lack of trust -lack of flexibility to change path depending on symptom change It is always good to encourage a second opinion as the patient should have the opportunity to see a subject matter expert, hearing it from a third party as a fresh perspective and having a chance to find someone to find a solution. Second opinions would help build trust, provide access to additional services or resources not available locally etc. Ultimate goal is to get the right diagnosis and best care to the patient.

Try to understand the physicians perspective and what they think about the condition. If they have a working diagnosis with a treatment plan or recommend a test, follow through with it. Even after that, if the physician is not able to diagnose the problem, there is always a room for a second opinion. In addition, sometimes asking the physician further questions may help you understand the diagnosis which physicians may already know, but not able to communicate well to the patient.

??Adherence to recommended follow-up appointments is crucial for managing both acute and chronic conditions effectively.?? While patients may perceive routine check-ups as redundant, these visits ?offer invaluable opportunities for physicians to monitor treatment efficacy, ?detect early signs of complications, and ?make necessary adjustments to care plans. ????Regular follow-ups empower patients to actively participate in their healthcare journey and contribute to optimal health outcomes.

You discuss with fellow colleagues. Or refer the patient to a subspecialist that encompasses the symptoms the patient is experiencing. Medicine is a team sport. Not one physician has the answers for everything. The time in which you think you do, you should retire.

Los síntomas son subjetivos mientras que los signos son objetivos. Pueden estar matizados por el momento de la entrevista, la empatía del doctor, la relación médico-enfermo, el parentesco con el paciente, incluso por el dialecto local. De lo percibido por la vista puede la experiencia interpretar el lenguaje no verbal. Llegando incluso a la ilusión de lo que quiere percibir del otro sujeto. Por eso, los síntomas pueden, en una historia clínica bien hecha, completarla, pero no son datos fiables para un diagnóstico actual. La evolución de la medicina científica a aquella basada en la evidencia ha hecho, junto a las pruebas físicas y a los signos cuantificables, que la sintomatología se haya relegado a la práctica de la medicina privada.

Como disse Willian Osler: Inspe??o, palpa??o, ausculta e CONTEMPLA??O (a reflex?o, a observa??o, a empatia, a preocupa??o, o cuidado).

La clínica es soberana.

While you make some valid points, your opening sentence seems judgmental and dismissive. And your closing sentence suggests a conclusion that I think rarely occurs.