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Dropping the Fear of Diagnosing

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A young child returned to the office for an asthma follow-up with his mother. I had been the one to finally diagnose him with asthma after months of recurrent respiratory symptoms and start him on an inhaled corticosteroid. In other words, I had simply done my job. I walked into the room hoping to hear that he was better but wasn’t prepared for what came next. She started by telling me that what I’d done had changed the life of her family for the better. They finally knew what they were dealing with and the Asthma Care Plan I’d given them afforded a newfound sense of control over a scary condition. And, of course, the child was having fewer symptoms. When I gave her samples of the corticosteroid inhaler from the sample cabinet, she said that it was all too much and asked if she could give me a hug. The younger me would have been too shy to accept the rhapsodizing and the request but the middle-aged me said, “but, of course”, or something to that effect. Besides, a quick glance at my clothes had assured me that I wasn’t covered in my favorite pooch’s hair or saliva.

This encounter lingered on my mind for days and despite being prone to over-analysis I kept coming back to just one thought. As doctors we do a lot more good than we realize and we should pat ourselves on the back more often. Self-congratulation is not something we are good at. When things don’t go as expected, we are quick to blame ourselves and indulge in self-doubt regardless of whether we had anything to do with the unsatisfactory outcome or not. We, however, never commend ourselves for all the good we do, all the pain and discomfort we alleviate. We all do this by practicing the bread and butter of our respective specialities but think of what we do as unsubstantial. This is because we usually find ourselves in a room full of doctors and believe that our job can easily be done by another. This could also be because we sometimes make the mistake of thinking of our patients as their diseases. If we thought of them as human beings in pain we would recognize that we were alleviating pain and suffering.

I invite my fellow clinicians to rejoice every time they diagnose someone with a painful condition such as an ear infection or strep throat because to that patient the relief we provide is anything but trivial.

I also urge everyone to not shy away from diagnosing someone with a chronic condition because in order to have a “plan” you need an “assessment.” You would not put someone on an inhaled corticosteroid and improve their quality of life if you didn’t diagnose them with asthma just as you would not place someone on an anti-depressant if you didn’t diagnose them with depression. Let’s get over this fear of giving the patient a diagnosis! What else are we here to do? Let’s, then, reassure ourselves and the patient that we are on the right track by giving them a follow-up appointment. And when they thank us, let’s be grateful for having had the opportunity to help someone.

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