10 Reasons Doctors Don’t Take Undiagnosed Patients Seriously

on 05 10, 2009

Doctor Doesn't Take Patient SeriouslyGetting doctors to take a health problem seriously can be one of the most significant hurdles undiagnosed patients face.  This is because primary care, specialty and emergency room physicians have their own hurdles to clear before they can truly hear what a patient is saying — and do the necessary amount of digging to find the true cause of an ongoing undiagnosed condition. Here are 10 reasons a doctor may dismiss your symptoms… or you.

For suggestions on how to proactively address these obstacles and increase the chances of proper diagnosis and treatment, read “How to Get Your Doctor to Take Your Undiagnosed Condition Seriously.”

  1. Think horses, not zebras. Doctors are trained and conditioned to look for the most common explanation, not the unusual one, because for the most part they deal in mainstream conditions that are reasonable easy to diagnose. In medical school they are taught “If you hear hoof beats in the park, think horses, not zebras.”This is generally good advice, since most of us who come in with a stomach ache or high blood pressure expect our doctors to treat the condition in a straightforward manner, not leading us down a rabbit hole of possible diagnoses. But when common symptoms mask a underlying problem that is unusual, this way of thinking can be just as dangerous as it can be efficient.
  2. By the book. There are established protocols or “recipes” for many conditions that instruct doctors on step-by-step procedures for identifying, diagnosing and treating. If a patient’s symptoms don’t match a protocol he or she is familiar with, the physician will be inclined to “turf” or refer a patient to another doctor who is more likely to be familiar with the protocol.
  3. Professional courtesy. There are invisible lines between doctors that they are taught not to cross.  If a specialist such as a nephrologist (kidneys) or endocrinologist (hormones) tried to treat your aching joints or a heart problem, he or she would be stepping on the toes of a rheumatologist or cardiologist…and they would be trying to practice in an area for which they haven’t received formal training. The referral system is in place to help prevent this and extend professional courtesy. Coming in to see a new doctor because a doctor in their group referred you means you’re more likely to be taken seriously, because you’re participating in the local physician’s buddy system. This can be a problem if you choose a specialist based on Internet ratings or word of mouth and walk in “off the street”. If you are “doctor shopping”, and while under the care of one practitioner you decide to go to another practitioner of the same kind and expect them to work together, this is a likely way to have one or both of them fire you as a patient.
  4. Revolving door. To stay in business, physicians have to keep the door revolving to appease health insurance companies and pay their employers or their own bills. So they allot a certain amount of time which includes the actual appointment, but also answering the phone, filling prescriptions, and other tasks related to an individual patient. Therefore, allowing medical curiosity to inspire researching potential diagnoses or creative problem solving, in their mind, detracts from time that could be provided other patients. Taking patients seriously takes more time.
  5. Clear communication. A language barrier exists between most patients and doctors. A physician’s effectiveness is dependent on how well the patient communicates with them, describing symptoms using words that mean the same to both doctor and patient. For example, a headache could be described as stabbing, dull, throbbing, pressure, tightness, burning, tingling or radiating. But if a patient has never experienced throbbing pain, they would not be able to confirm for the doctor if that word describes their pain.
  6. Shooting in the dark. Lack of pertinent information forces doctors to work in a vacuum. If patients provide limited or incorrect information about patient medical history, family medical history or current symptoms because they don’t know, don’t remember correctly, are embarrassed, or haven’t recognized a problem they’ve been living with (such as snoring) as a related health problem (sleep apnea), a physician is challenged to make a correct diagnosis.
  7. Self preservation. Manipulative patients who are trying to get the doctor to do something for them such as prescribe medication, diagnose an uninsured friend by reporting the friend’s symptoms as their own, etc. do genuinely undiagnosed patients and their doctors a major disservice. Other patients may want a doctor to “fix” them without having to do anything themselves such as changing their diets or taking medications when appropriately prescribed. Such abusive and uncooperative patients can burn a doctor enough that they avoid any case that looks like it’s gone nowhere before.
  8. Limited liability. Some doctors avoid making a diagnosis because of the increased liability and cost to their practice in regards to health insurance. They selectively choose patients they can treat with ease. Others are unwilling to run tests because they don’t feel comfortable interpreting the results. Or they avoid following up on tests requested by other doctors because they don’t understand the context in which the tests were requested, and don’t want to be accountable for decisions made by others.
  9. Too much work. Sorting out overlapping conditions, an unusual combination of symptoms or complex cases can be intimidating to any medical practitioner. If you have a thick medical file, or a long list of previous doctors, a doctor may think “if other doctors haven’t been able to help her, I probably won’t be able to either”. This is especially true if the doctors you’ve seen are at respected medical facilities like Mayo, Shands, Cleveland Clinic, Johns Hopkins or Cedars Sinai. Or, the doctor may be simply stumped and unwilling to do the necessary research or confer with other doctors.
  10. Head cases. Some doctors consider specific diagnoses to be red flags to warn them that patients may have mental problems or represent other kinds of “trouble”. (Fibromyalgia has had this stigma in the past, but is now receiving increased validation from the medical community as a “real” syndrome). The relationship between thoughts, emotions and physical ailments is real and tangible. A perfect example is thinking of someone close to you who died… The thought creates sadness, which leads to tears. Thoughts can be so powerful as to give a woman who isn’t pregnant all the symptoms of pregnancy. Doctors witness the power of thoughts and feelings on our bodies every day. If medical tests come back negative, or symptoms are not visible or reproduceable during the appointment, they can’t rule out the role our heads and hearts play in our health. Their own belief and value systems contribute to the decisions they make about us and why we’re sick. They may look at us and identify real mental or emotional states that are contributing to our physical distress, or may interpret what we say and do inappropriately based on their own assumptions, and send us off thinking it’s all in our heads.

For suggestions on how to proactively address these obstacles and increase the chances of proper diagnosis and treatment, read “How to Get Your Doctor to Take Your Undiagnosed Condition Seriously.”

Comments (15)

 

  1. X Endurance says:

    I think #8 is the most prevalent reason. Malpractice suits based on a doctor’s performance, or lack thereof, are too common these days.

  2. Anna says:

    I understand that. And the people who repeatedly bring up false malpractice suits should be ashamed of themselves. Because it’s just like rape, nobody takes it seriously because there are too many people out there who just want to make a quick buck or get their fifteen minutes. But there’s negligence too, and what I don’t understand is that so many doctors believe what other doctors say. So if they write something slanderous in your medical record they are basically sending you off undiagnosed hoping that you won’t die so the family can bring up on negligence. It’s ridiculous. Doctors used to be doctors because they wanted to help people’s healths, not for fortune, or power. Some might say status but ultimately it comes down to power.

  3. erica says:

    I can relate to #8 # 10 D octors are very lazy these days, i’m constantly telling my Dr. Theirs something seriously wrong with me, i’m having chronic pain throughout my body. She does nothing.

  4. erica says:

    She tells me without any blood work are physical and saids it fibromyagia.. I tell her it’s difficult to walk, oh just ice it…. Like Duh!!

  5. erica says:

    They just don’ t have qualify doctors like they use to. It’s all about money these days. These doctors don’t give a s%#* about their patients..

  6. erica says:

    I had to push my previous Dr. To run some test, because my blood pressure remained very high 178/98 for 3 months all he would do is increase my meds still my b/p remained high. So i decided to do my own research and google what can keep my b/p high even with treatment, so several things i read matched up to what my syptoms was. So i email my Dr. And please blood test to see if any of these what’s causing my b/p to stay high. And to make a long story short, BINGO he set me up with a specialist, i had a disease that cause my b/p to remain high. Now today i’m on a special med to treat my illness. Now what would of happened if it left untreated?? My Dr. Was to damn lazy to do the research…

  7. erica says:

    I think they think i’m bi polar are something. .. Now my new DR. Is doing the same thing. WOW!!! I NEver these problems in the 80’s 90’s these doctors are lazy and dont want to paper work etc.

  8. erica says:

    And i tell my Dr. I’m having trouble losin weight, she then goes and tell me to healthy etc. I tell her i eat very healthy etc. Very low carbs, mostly veggies raw no sweets or soda’ s etc. I told i follow Dr. Oz program to a T And she looks at me as though i’ m lying or something. She don’ t believe me. I told can you do some test to see if theirs some underlyin issue, and again no responce. Later when i get home i check an email left me a list of foods that i should be eating excercise as a plan to which i told her i excercise every day 2 times a day 7 days a week!! she still won’ t run a test. I’m on a serious mission to find a good doctor. If anyone know a good kaiser dr. In the San francisco Bay area please let me know.. Because its been difficult..

  9. Anne says:

    I generally have admired and respected doctors. However, I feel when it comes out that you have a mental illness, they stop listening. My doctor was wonderful (in some ways, still is) the first 2 years I had him. However, when I started needing more anti-depressants, he dealt with my issues without giving me the benefit of the doubt and acting skeptical (almost like I’m a joke). I am not without understanding that doctors have boundaries and rules they have to follow. However, I did NOT ASK FOR ANYTHING I’VE STRUGGLED WITH! Please, doctors, open your mind or you will lose patient, not only from those finding another doctor but some who will die because you didn’t believe.

  10. Anne says:

    I generally have admired and respected doctors. However, I feel when it comes out that you have a mental illness, they stop listening. My doctor was wonderful (in some ways, still is) the first 2 years I had him. However, when I started needing more anti-depressants, he dealt with my issues without giving me the benefit of the doubt and acting skeptical (almost like I’m a joke). I am not without understanding that doctors have boundaries and rules they have to follow. However, I did NOT ASK FOR ANYTHING I’VE STRUGGLED WITH! Please, doctors, open your mind or you will lose patient, not only from those finding another doctor but some who will die because you didn’t believe.

  11. Ellen says:

    Anne, I’m sorry to hear that you don’t seen to be taken seriously by your current doctor. Please consider asking your doctor for a referral to a psychiatrist – a doctor who is specifically trained to diagnose and treat mental illness.

    There are also natural remedies that can be quite helpful in alleviating depression, including SAM-e which is a natural substance produced by your body. Taking SAM-e is similar to a diabetic taking insulin because their body isn’t producing enough insulin.

    SAM-e is available at stores like Wal-Mart and Walgreens, and costs about $35-50 for a months supply. It shouldn’t be taken with other antidepressants, and will take several weeks to see the full effect. It should NOT be discontinued abruptly after you’ve been on it for a while, or it can make symptoms worse. It should be weaned off slowly over a couple weeks.

    SAM-e is not recommended for people with manic/depressive or bipolar disorder, or those with a family history of it.

    Just a reminder – I’m not a healthcare professional, just a fellow patient who is trying to help others avoid the same struggles she went through.

    Don’t give up seeing help until you get it! Get creative in your strategies to find the right doctor for your current situation, and keep advocating for your health. You deserve it! 🙂

  12. Sally says:

    After a head-on car wreck, I did not receive adequate medical attention. I should not have been removed from the vehicle without a backboard or neck collar, the ER X-ray tech should not have put his hands on my newly injured shoulder, my sternum, shoulder, neck, entire back, and ribs all should have been x-rayed. I had no insurance so I was brushed off & my injuries went untreated. After being dx with PTSD and 3 other anxiety disorders as a direct result of the accident, I was then told awful things that indicated my pain was in my head- even though I had x-ray & mri images that proved I was going paralyzed from the waist down. Fast forward 10 yrs, I get injured and fear a broken rib. ER Dr. asks me when I broke my lowest rib. I told him about the accident and he stated that would perfectly explain the age of the now healed break as well as the angle (from the seatbelt). Forward 5 more yrs, I fell and injured my arm. I’ve been fighting to get an accurate dx and proper treatment for months. Unfortunately, the idiot pcp I used to have stated that I was filing for disability due to my arm injury (which is incorrect. I was filing because of my anxiety disorders that make my life a living hell). So, I switched to a different pcp and have no hope that this one will help either. I am in serious pain, can’t feel my thumb, and this is my dominant arm. I was told the MRI on my neck doesn’t show anything and I should consider acupuncture. It took all I had to not say that I should consider suicide because I cannot live like this anymore and my pleaz fall on deaf ears. I am not asking for meds, in fact I detest taking the ones I need to for a genetic disease. I really am at a loss and life is truly not worth a damn anymore. Thank you to all the so-called medical professionals for doing nothing but making it worse.

  13. amy hopple says:

    I have bee sick for years, nausea and dry heaves are a constant reminder that I am not well, my Dr. won’t even try to help.. it is all in my head! No, not really! I gave up going to the Dr. and maybe they will figure out what is wrong with me at my autopsy

  14. Ellen says:

    Hi Amy… I’m sorry to hear you’ve been having a rough time. Have you heard of Cyclic Vomiting Syndrome? It can cause ongoing nausea, and is often triggered by anxiety or spicy / citrus food. If you would like to send me a message using the contact page with a more detailed description of your symptoms, I may have some information that could help about various causes of nausea (I’m not a medical professional — just a fellow patient with lots of experience). -Ellen

  15. Alan says:

    Amy im the same way and way more i lost 60-70lbs and my body is shutting down and no drs will help one even sed it was in my head. Im tired of bein alive im getting sicker by the day and no dr will help. Wish i could find one that will help. And thats what i tell em. I need help please help me but no. So when i die ill make sure they get a letter thankin them for my death

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