Dec 16, 2014

Scott: How do yous tell your dr. what's wrong with you when you can't fifty-fifty yourself really put words to information technology and communicate what it is? We'll requite y'all some pointers on what yous tin do so you can get amend next on The Scope.

Announcer: Medical news and research from University Utah physicians and specialists you tin use for a happier and healthier life. Y'all're listening to The Telescopic.

Scott: Dr. Miller I take a feeling that at that place are a lot of patients out there that maybe aren't feeling 100%. They're not healthy merely they actually can't describe what their symptoms are.

Dr. Miller: But they're worried about it.

Scott: But they're worried about information technology or they just want to feel amend. Right?

Dr. Miller: You know information technology's not something that's just happening over i or 2 days, just maybe information technology's been going on for several weeks.

Scott: Yeah but they're afraid. It's like when you go to the auto mechanic. By the time y'all become to the medico the machine mechanic is going to take to beginning throwing parts at the problem.

Dr. Miller: Information technology's a piddling bit overwhelming to come to the doctor's office and enter this large medical system where many things might happen.

Scott: Yeah, and so we're afraid you're going to start throwing tests at this problem and we're never going to discover out what's wrong.

Dr. Miller: I think that inhibits people from coming to the doctor. So in reality, Scott, many times the diagnosis tin can be arrived at through a history and a physical.

Scott: Even If I just have vague symptoms?

Dr. Miller: Absolutely. And I think some people believe that rightly or wrongly they will need imaging. So a CT browse or an MRI or they'll need a lot of blood piece of work or they'll have to go onto a treadmill. They might think a test is going to give them the answer. And that'due south not true. At least initially.

Scott: Okay.

Dr. Miller: And the other role of that is, or on the opposite side of that, patients might not desire to do that because they don't have the funding to exercise that. They don't accept the money to do that and so they're afraid that the physician is going to club many tests that they can't afford and that volition just confuse things even more than for them. They just want straight talk.

Scott: They want straight talk so want to experience better and they don't want to have to take a lot of pills or do a lot of tests or come back to your office 8 times.

Dr. Miller: Right. So two camps. 1 camp of patients might desire testing that they think will brand them meliorate when in fact they don't need specific testing. They demand to have a adept history and a concrete. And the other set up of patients might somewhen demand testing just they are worried at the become go you're going to run up a whole agglomeration of bills performing tests. And that's not truthful either. It begins with a history and a concrete.

Scott: That's your beginning line when somebody comes to yous with this sort of a problem, y'all start doing a history. And how?

Dr. Miller: It'southward an historic period old approach to taking care of illness and it's withal the best way to practice it.

Scott: And how?

Dr. Miller: It'southward absolutely the best fashion to do information technology.

Scott: How oftentimes do you effigy out what'due south going on merely from that first step?

Dr. Miller: Probably 90% of the time we'll figure out what's going on or y'all'll have a general thought. You can create broad categories of diagnoses and those tin can be sorted out usually within the get-go visit for the patient by taking an adequate history.

Scott: So y'all exercise that history. What about for the 10% that that doesn't help? What would happen at that point?

Dr. Miller: It depends on what yous find out. Then that'south a piddling chip hard to sort out. Merely I remember the message here is that patients coming into the office will have some blazon of an answer past the end of the exam so a more focused approach to what testing will be needed. And most of the time that testing is non all-encompassing.

Scott: Yeah. Have you ever had a case where you couldn't figure something out?

Dr. Miller: Sure. Certain. It takes a while and sometimes you don't figure it out. That's rare. That's not very common. In general when you can't effigy it out or put a name to it, the patient continues to do well. They may accept complaints but in general it isn't a life threatening or chronic condition for them.

Scott: So you could take some relief in that.

Dr. Miller: They tin and I can and you go along the door open and they go on coming back. If reassurance is important for them then that is an important thing to provide. Reassurance is a very constructive treatment sometimes even when you can't find a diagnosis. Just you tin say, "I don't think this is going to lead to something terrible."

Scott: Is in that location something that the patient tin can do before they come up to visit you lot for that first time to prepare for that kind of history probing that you're going to do?

Dr. Miller: Well we talked virtually this in another interview and I think that chief matter for them is to write downwards a set of questions before they get to the doc'due south office because many times patients sort of lose their words by the time they get in to run across the doc. They are a little flake broken-hearted and they don't remember all the questions that they wanted to ask. And so writing downward those questions earlier they come in is important.

Scott: And those specific symptoms?

Dr. Miller: Right and sometimes bringing a family fellow member to double check what they are seeing and thinking. Particularly in the older patients information technology might be very helpful. Especially if in that location's issues of memory and forgetfulness associated with how they're interim and feeling.

Scott: So lesser line. If somebody is not feeling well they actually should just come up to see y'all because odds are y'all're going to be able to figure information technology out in that one visit.

Dr. Miller: Right, they should be able to go and see a primary care physician or a provider who provides primary care and inquire questions. Spend some fourth dimension having a physical and history and that'southward the beginning of the process of learning what is going on. I would say the majority of times, it'south not usually something that is seriously incorrect.

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