Inside a Doctor's Diagnosis
The "Doorway Diagnosis"
Even before you say hello, your doctor is already assessing the way you sit or stand, the tilt of your head, your complexion, and other aspects of your appearance to assess whether you look healthy or sick. For instance, an unusual pallor may suggest anemia or extreme pain, while bloodshot eyes could mean a fever or a virus, explains Jerome Groopman, MD, a professor of medicine at Harvard Medical School and author of How Doctors Think. Just by looking at a patient who appears unwell, the typical doctor comes up with two to three possible diagnoses within minutes, says Dr. Groopman. He or she may also already be forming an opinion about how easy or difficult a patient you are likely to be. Of course, the doctor could also be wrong, especially if you don't look as ill as you feel; maybe you're always cheerful and energetic or just came from the office and are wearing makeup.
YOUR JOB: To make sure your doctor doesn't get the wrong first impression of your situation.
WHAT TO DO: "Don't hide how you feel," advises Dr. Groopman. "If someone is pale and anemic I don't want her coming in with rouge on her cheeks. We need patients to help us think, both in terms of giving us information and keeping us from making errors." "Let your doctor know what you are most concerned about at the start of the visit," advises Dr. Frankel. "That will almost always ensure that your doctor will listen more carefully." Describe your symptoms concisely but thoroughly. It's not enough to say "I feel lousy" or "my shoulder hurts." Instead say "I started feeling nauseous five days ago and I get a pain in my stomach about 15 minutes after I eat." Or, "I have a dull ache in my shoulder, but when I swim -- which I do five days a week -- I feel a sharp pain."