Monthly Archives: October, 2012

Seeing vs Recognizing What’s In Front of You

There is a vast difference between seeing something and actually acknowledging the existence of something. Our eyes allow us to visualize the numerous stimuli we encounter on a daily basis, but we oftentimes fail to actually see what is in front of us. In order to more fully understand this concept, watch the video shown in the following link. Be sure to follow the instructions.

http://www.youtube.com/watch?v=vJG698U2Mvo

Although this isn’t the case for everyone, the majority of individuals who watch this short clip fail to notice the entire situation in front of them. The same can be said when we drive a car and our mind wanders, only to realize moments later that you’ve been driving and not really paying attention. Yet, your eyes were indeed seeing everything in front of you and you just didn’t attentively acknowledge what they were seeing.

A physician must develop a keen awareness for not only seeing what is presented by a patient, but acknowledging all possible signs, symptoms, diagnoses, etc. in order to make a fully investigated decision. One must develop the ability to recognize all of the clues they are presented with.

Although I have read and investigated this concept years ago in my life, I would like to give credit to the book Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis by Lisa Sanders, MD, referenced on my recommended reading page. Within this text, the topic above is discussed in more detail and brought my attention to the subject matter once again so that I felt compelled to write this blog post.

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Quote of the Day

“How sick a patient looks is just a clue, a single piece of information. Alone it is practically meaningless.”

-“Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis“, Lisa Sanders M.D.

This quote is taken directly for the book referenced above. The statenment is simply, but the concept behind it is a substantial one that all medical personal should acknowledge. A patient with a simple virus can appear to be deathly ill, while someone with a life-threatening complication may look completely normal in appearance.

Do not make the mistake of diagnosing a patient based on visual cues alone. Further investigation is always worth the extra effort to prevent misdiagnosis and failure to treat a life-threatening complication.

Quote of the Day

“I have no special talent. I am only passionately curious.” – Albert Einstein

Organic vs Conventional Produce

A recent study by the American Academy of Pediatrics found that the benefits of children eating organic produce compared to convential produce is essentially negligible.  It makes a point to clarify that parents should be most concerned with making sure their children are simply eating fruits and vegetables and place less concern on the source of the produce.  Although this in no way disproves any benefits of organic foods, the study demonstrates that any benefits are not readily identifiable. The full article can be found here http://www.medpagetoday.com/MeetingCoverage/AAP/35501?utm_source=share&utm_medium=mobile&utm_campaign=medpage%2Biphone%20app from www.medpagetoday.com

Baby Formula Increases Risk of Leukemia

From www.medpagetoday.com, the article can be found here:

http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/35390

Main Point: The study shows that extended formula feeding could increase the risk of pediatric acute lymphoblastic leukemia (ALL) by as much as 14% each month.

Primary Source: American Association for Cancer Research Frontiers in Cancer Prevention Research
Source reference:
Schraw J, et al “Longer formula feeding and later age at introduction of solids increase the odds ratio of pediatric acute lymphoblastic leukemia” AACR-FCPR 2012; Abstract A102.

The #1 Diagnostic Tool

The #1 diagnostic tool that a physician can employ is simply…. the patient’s story.

Oftentimes, physicians immediately begin their investigation by probing the patient with a general list of questions meant to quickly surmise the problem and in return, allow immediate interpretation of the problem. However, what if the problem isn’t quite so simple?

Misdiagnosis is an incredibly frequent phenomenon in the field of medicine, and it should be a top priority of a physician to reduce the incidence of misdiagnosis as much as possible. By allowing a patient to explain the entire situation leading up to the onset of their illness/injury, you will obtain much greater amount of information and probably more than is necessary. However, you will also be much less likely to immedately assume the most simplistic diagnosis available and undoubtedly reduce the number of inaccurate diagnoses. It’s understandable that some patients are less inclined to ramble about every detail of their problem and extreme introverts may avoid talking altogether. In such a situation, a physician must ensure that the questions are completely general in nature. A question should not coerce a patient to answer in a specific manner but should allow them to develop their own interpretation of the events leading up the illness/problem and the signs & symtpoms that accompany it.

However, it is also necessary for a physician to work as quickly as possible based on the frequently changing standards expected by them. Physicians are unable to spend an extended amount of time with a single patient due to pressing expectations that they see and treat as many patients as possible. This puts them ‘between a rock and a hard place’ so to speak in that the are expected to treat without error, yet as quickly as possible! Therefore, I am not saying a physician dedicate so much time to preventing misdiagnosis that he neglects other duties and falls behind his patient quota. Furthermore, I am not saying to order unneccessary tests ‘just to make sure’ as this would be time consuming, expensive, and possibly painful for the patient. However, it is important to maintain an open mind to the endless possibilities of ALL signs and symptoms a patient presents. Let the patient explain everything that is taking place before you make your decisions. In summary, just let the patient talk!

Quote of the Day

Taken from “Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis” by Lisa Sanders, MD.

“A man isn’t dead until he’s warm and dead.”

 

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