Why you should listen to and believe your patients. Twitter thread by a doctor

Copy of tweets


I saw a patient and diagnosed them with a common condition. However, I was wrong. How did I know I was wrong?

Because the treatment wasn’t helping and the patient was feeling worse. 1/

I did some tests to evaluate for other conditions. They were all normal. I began trying to treat the symptoms because it was affecting quality of life. I still went with the original diagnosis. The patient continued to decline. 2/

I decided to start fresh and re-evaluate the patient as if they were a new patient. They had developed a new symptom that did not fit with the original diagnosis. I began searching for other conditions that weren’t so common. 3/

I referred the patient to a subspecialist. They made a diagnosis that was never in my differential but seen by people in that subspecialty. We did the confirmatory test which was positive. We had the correct diagnosis and patient was switched to correct treatment. 4/

If I hadn’t listened to the patient or if I hadn’t believed the patient, or worse, if I blamed the patient for not getting better, this story would have ended differently. I hear so many stories of patients not being believed, especially when the tests come back normal. 5/

Well, here’s an example of me not ordering the test that gave the answer. But more important, I re-evaluated and reconsidered and eventually realized it was beyond my area of expertise. I didn’t know what this patient had but I got them to a doctor who did know. 6/

Doctors are not magical and know everything. We are sometimes wrong when we make a diagnosis. And that’s why we need to listen to patients when they say how they’re feeling. We should always reconsider the diagnosis with every visit and confirm we have the right one. 7/

And we should not be upset by a second opinion. Because at the end of the day, the important thing is the patient, not the doctor’s ego.
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The thing I find most concerning about this doctor's tweets is that it's considered worthy of making a series of tweets about as if it's unusual. Surely this is what medicine is about all the time. Every time someone isn't responding to treatment, or gets new symptoms, surely the role of the doctor is to reconsider their initial diagnosis, continue investigating and to refer to a specialist if they can't find the answer.