(as published in the Syracuse Post Standard, May 24, 2011)
Before I began my patient empowerment work, I thought a specialist was someone who had learned all the general medical information, and then chose to concentrate on that one body system or disease that held the most interest for him. Turns out, that’s not exactly right.
In fact, medical students who choose any specialty except internal medicine get only two years of basic medical education before they jump into specialties. That’s not very much, really. So, while they develop extensive knowledge of one body system or disease, their broader knowledge of the body and its problems may be lacking.
Why is this important to us patients? Because sometimes our symptoms aren’t clear cut. If we visit the wrong specialist, he may not know enough about the basics to help us.
Example: A woman with an upset stomach is sent to a gastroenterologist. He runs tests, but they are inconclusive. He tells her there’s nothing wrong, that it will pass. But she gets sicker, and still the gastroenterologist can’t diagnose her. Why? Because she has ovarian cancer. She needs a gynecologist.
Another example: A man visits his primary care doctor complaining of achy knees and wrists. The primary, suspecting arthritis, sends him to a rheumatologist who prescribes a pain reliever plus an anti-inflammatory medication. Despite the treatment, the man’s symptoms get worse, and new ones appear – vision disturbances, heart palpitations. Still, the rheumatologist has trouble controlling the symptoms. Why? Because the man has advanced Lyme Disease. An infectious disease specialist might have diagnosed him correctly.
So what can we patients do differently to be sure we are getting the information we need?
Seeing the wrong specialist may mean we get the wrong treatment, or no treatment at all. Some doctors, lacking the necessary knowledge, will not diagnose medical problems like fibromyalgia or chronic fatigue syndrome, or even Lyme Disease, because they weren’t educated during a time those diagnoses were named. Patients may be prescribed drugs that mask symptoms, meaning that in addition to not getting better, it will be difficult for them to be diagnosed even if they do eventually see the right specialist.
If your symptoms aren’t clearing up as expected, or you feel as if your doctor is missing pieces of your diagnosis puzzle, ask your primary what other specialties might be considered. Because it’s true: what your doctor doesn’t know really can hurt you.
…………. ADDITIONAL RESOURCES ON THIS TOPIC ………………
Are You Seeing the Right Specialist?
When You Can’t Get a Diagnosis
A Doctor’s Medical Training and Experience
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