First Obstacle to Get Past in the Doctor’s Office

Be cautious in a doctor’s office that has the nurse interview you at the beginning of your office visit, and she writes some things down for the doctor before the doctor comes in. Chances are she will not write down everything you tell her, and she may not use your and it’ s own words– both of which may be important for your correct diagnosis.

Some doctors do this because an x-ray or lab test can be ordered right away, and would need to be done before the doctor makes a diagnosis, and that makes sense. Also, if you have a pretty simple problem like just a sore throat, there may not be any harm in this approach.

But other times, it can be a “shortcut” for a doctor who really should be hearing all of your symptoms for himself, but he thinks this is a time-saver. When that is the case, and your doctor doesn’t take the time to ask you himself what the problems are, then that’s a red flag that he’s having to move too quickly to really do the “best” by you.

Another problem with this approach is that if the nurse listens to you and then writes down things in her own words, then that can set the doctor up for an error in diagnosing your illness. Why? Because authorities on making correct diagnoses say that why you’ve come to the doctor that day should be restricted to what the patient says, and it’s best when it’s in the patients own words.1 This is important because if the nurse writes down things in her own words she is doing the interpreting and diagnosing that the doctor should be doing, and that has the potential of unintentionally leading the doctor down the wrong diagnostic path. It is a common cause of misdiagnosis. Don’t let it happen to you.

This type of misdiagnosis is caused by “error due to inheriting someone else’s thinking”1 and this particular error causes the doctor to lean toward a particular diagnosis “as a result of a judgement made by another caregiver early in the patient care process.1

What to do if you’re in this situation?

If you have a medical condition that seems serious or is not getting better, just make certain you repeat to the doctor the main reason you’ve come in, and then repeat all of the things you said to the nurse, so he’s certain to hear them. Alternatively, if you find yourself in this situation, say as little as possible to the nurse about your illness– just enough to give your main symptom and satisfy her. When the doctor came in, say “I need to tell you more about what’s going on” and then do so.

Studies, Footnotes and Resources:

  1. Campbell, Samuel G., Pat Croskerry, and William F. Bond. “Profiles in Patient Safety: A ‘Perfect Storm’ in the Emergency Department.” Academic Emergency Medicine 14(8) (2007): 743-749