I thought I
would write about the top doctors in Tassie. From the point of view of someone
who is not a doctor. But like all of you, has at times been sick and needed a doctor.
Doctors are
just like us. Sometimes they do the right thing. Sometimes they make mistakes. They
have good and bad days. They have good and bad times during any one day. Their
recent continuing education may be related to your present complaint. It may
not. Recent patients may have presented with similar diseases. They may be distracted by their home life or
their kids or their aching back. Their
workmates may be helping, hindering or distracting them.
Let’s
assume your doctor is the top doctor in Tassie. They have good reputation and have
many patients. The only way they can see many different patients with many
different problems in the one day is to have a routine. To routinely do and say
the same thing.
When you
present to their clinic your doctor will start by writing down why you are
there. They will probably call it your chief complaint. They will write down the story about your
chief complaint. Where does it ache? How long? What makes it worse?
After
hearing about your chief complaint your doctor will begin to assume. Do I know
what I am about to do or do I have no idea where this will lead? Has she fallen
and broken his arm? Straightforward. Is
he feeling a bit tired? More complicated.
After listening
to why you are there, your doctor will sit in front of you with your medical
record.
They will look
at your medical record and check for notes about:
Medical
history. Chronic diseases. Major illnesses.
Surgical
history.
Medications
taking and medical allergies.
Family
history. Some diseases are genetic.
Habits. Such
as tobacco, alcohol, exercise, diet.
Immunization
history.
Emotional and
social history.
Mental history.
After
listening to why you are there, and reminding themselves who you are, your doctor
will then do a physical examination.
They will
modify their physical exam based on your chief complaint. But they need at all
times to know what a complete physical exam is.
Everybody
has their routine for a complete physical exam.
One common
routine is to go in the following order. Starts with the vital signs.
Temperature, blood pressure, pulse, rate of respiration.
Then exam
the head/neck, chest, heart, abdomen, extremities. Followed by sight, hearing, touch and occasionally
sense of smell.
There are four
basic elements to a physical exam. Inspection, palpation, percussion and
auscultation. Palpation will involve use of hands to determine size, shape,
firmness, location. Percussion will involve tapping on the surface to hear the sound
made. The sound will determine whether the structure is hollow or solid. Sensations
felt by patient may help with diagnosis. Auscultation means to listen and is usually
done with a stethoscope.
After
listening to your chief complaint, reviewing your medical history, and doing a
physical examination your doctor should have a diagnosis. They may call it a provisional
diagnosis or differential diagnosis if there is a need for tests.
Tests such
as lab tests, X-rays or MRI.
After
receiving the results of the tests your doctor will have what can be called a definitive
diagnosis. The definitive diagnosis will give a name to your illness. The definitive diagnosis will fit with all
the signs and symptoms. A sign is what the doctor sees. A symptom is what you
notice.
Your doctor
will then follow their naming of your illness with a management plan.
That is management
of the disease that you have. Management will normally involve doing a number
of things. Such as rest, using crutches and tablets. The medications prescribed are only one part
of the management plan.
Your doctor
being one of the top doctors will follow the management plan with prevention. Prevention
involves knowing the aetiology and knowing how to avoid it. Your doctor will
know how to prevent most maladies they see. They will know how to prevent most
common illnesses. They will know how you can live a long healthy and happy
life.
