I was sitting in a conference non-related to medicine, and one of the panelist shares that she was worried about her daughter because she wasn’t like her other children. The mother shared her daughter was “different.” She took her to several physicians and shared that, after several physicians, she found the one. They later diagnosed the child with Autism and ADHD, and a few other diagnoses. The mother shared she was relieved to have found a doctor that believed her.
Medicine has changed in the past decades. We have advanced immensely in diagnostic methods, treatment methods and have promoted mental health awareness as much as possible. This has led to successful diagnosis, and ultimately lives saved. But in the midst of these positive effects of the advancement of medicine, we have had some negative effects. One being the conditioning of physicians always needing to diagnose, because medicine is meant to diagnose and treat. We have forgotten though that some days, there isn’t anything to diagnose. There will always be something to do, but there will not always be a diagnosis.
Not giving a diagnosis to a patient isn’t so easy though. As doctors have been conditioned to always diagnosis, patients have been conditioned to always receive a diagnosis. If they don’t receive one, they believe the doctor has done a bad job. We have reached a crisis in the medical and patient community that is only worsening and, costing hundreds and hundreds of dollars. This crisis is more present in some specialties versus others, for example in psychiatry where an EEG, MRI, blood work or CT will most likely not give you a diagnosis. We also have the issue of technology. With the increased social networks and technology sometimes patients themselves already come with a diagnosis and just go to the doctor so they can give them that paper with a diagnosis and treatment. We even have apps today that are free to the public where they can put their symptoms and BAM, they got a diagnosis.
We obviously have several legal, ethical and educational hoops to climb before we can once again tell a patient, that they are thankfully fine, but there are things we can do to take a step forward, starting by insurance. Insurance needs to move away from requiring a diagnosis for everything, and doctors need to move away from always believing a diagnosis is present and patients need to remember that just because they or their child is “different,” doesn’t mean they have a diagnosis.
We need to remember that there is a line where being different is normal. In other words, kids will be kids. Kids will run around, jump, have behaviors, have different manners of socialization, different likings, etc. We need to remember that not all that is different is a problem.