Diagnosis
The obvious question that patients want answered when they see me is, what is wrong with me? Usually tacked onto that question as well is, what is my diagnosis? Anyone that has come to see me, or chatted with me will know that I’m not a big fan of putting a diagnosis label on things. This is mostly because I don’t think that the diagnosis terms we use in medicine help me to treat a patient.
Let’s take rotator cuff disease, for example. From ages 14 to 84, when I have a patient that comes in with shoulder pain, one of the biggest questions I get asked is, “is it my rotator cuff.” Unfortunately, though, it’s not always that simple. I think our medical establishment has accustomed many to look for this answer because for many of those treating those conditions, they can possibly offer a treatment that will “fix” their problem.
The reality is, that’s usually not all that’s going on. Sticking with this shoulder pain example, you might actually have a small tear in your rotator cuff, but telling you that your problem is from your rotator cuff would be doing you a huge disservice because if I don’t figure out why your rotator cuff became overstressed, than no matter what i or anyone else does to fix the rotator cuff, you will still have the dysfunction that led to the rotator cuff disease.
Sports medicine offices around the country are filled with patients that have already have rotator cuff surgery on either that same side or the opposite simply because the treating physician never bothered to examine what led to the rotator cuff dysfunction to begin with. I simply can’t do that.
My conscience weighs on me too much when I provide a 10 second answer to a much bigger problem. And in order for me to know what the much bigger problem is, I have to be able to evaluate the other structures involved. Only then can I really know what is going on with your shoulder and only then can we, together, come up with a plan to help your shoulder pain.
I know this might be hard to swallow because we want answers and we want them right away. We want to know what the lab result is. Or that MRI. And those tests can possibly give us an answer and then we will at least have an answer. But what good is an answer if you still have the problem. I would much rather fix your problem than give you an answer. I would much rather you be better, than provide you just with a diagnosis. At the end of the day, what matters is you living the life you want to live.
