When you go on a train journey, sometimes things go wrong. But passengers are much happier if they know why, how long it will take to get fixed, and are they going to get there. Humans and illness are similar.
In any interaction with one of us, the patient must come away from it, with these pieces of knowledge:
1. Diagnosis. This the cause of the patient’s problem. “Back pain of unknown cause” is not a diagnosis. That requires a full history, examination and investigation (that may include an MRI scan).
Language
Language is very (very) important for a doctor. Think befow you speak. How will the thing you are about to say be interpreted? Get it wrong, and you will lose the patient’s trust.
In this way, it is important for all health professionals to be precise in their language. For example, phrases like ‘urosepis’, ‘chest infection’, ‘Trop-T negative chest pain’, ‘off legs’ or ‘acopia’ are not syndromes or diagnoses. ‘Bed-blocker’ is plain rude, unkind, and shows a lack of respect for the elderly. These are all ‘non-diagnoses’. They are not helpful, represent sloppy medicine and are to be avoided.
2. Prognosis. This is a fancy doctors phrase for outlook, i.e. what will happen to the patient. They need a good idea whether the problem will get better, stay the same or get worse – and over what time period. Then they can plan their life, and do what they need to do to help themselves.
3. Hope. Hope seems a vague idea. We cannot define it. But it exists. It is vital that a health professional gives the patient hope. As it is by having hope, with a prognosis, that they can take responsibility and contribute to their healthcare. There are always things they can do.
There is more information on how to do all this in self-management.
We have described 3 duties of a doctor – diagnosis, prognosis and hope. We hope it has been helpful.
