Thread by @DrSeunO

The greatest tool a doctor in a making a diagnosis is not the stethoscope he carries around his neck. It is his/her ability to take a good history.
Sadly this is as much the doctors job as it is the patient job

A thread to make the best out your medical consultation fee.

Consultation:a meeting in which someone talks to another about a problem or a question
A discussion about something to be decided.

Disclaimer: this thread is not a template for an ideal consultation.
Doctors finesse their consultation skills as they gain experience, some faster than other.
So don't go about looking for a doctor with best consulting skills. Work with your doctor, play your own role

In my 7 years of medical practice, one of the problems I have had to face is getting the right history from a patient, not because I'm not good at it (although I secretly wish, I could pay someone to clerk for me😉😁)

But rather, the average Nigerian patient seems not to know what a medical consultant is all about.

Most of them come unprepared and end up being interrogated rather than conversing with their doctor.

Let give an example

After introducing myself:

Me: so what can I do for you today?

Patient (P): I don't know what is wrong with me

Me

Another one

Me: what brings you to the hospital today?

P: Doc, I have headache?

Me: Tell me about this headache

P: All I know is that I have headache, it is just there in my head.

One of the first thing that struck me, when I started practicing in the UK, is how easy it was to take a history from a patient, I was so amazed that I discussed with a fellow colleague @don_C1. He had the same experience
So I set out to know what was the difference

One thing was constant... I hadn't changed my consultation skills. You see the British gives you a story, a story from when they were in their usual self to when the symptoms started and how it has affected them, they tell you how far they have gone to help themselves

You see the Nigerian patient goes to the hospital without a plan, a goal, what they want to achieve with the cash they are about to pay the doctor. They come unprepared for that appointment

Some don't even understand how their symptoms has changed or affected them

When you walk into a doctor office you must have a plan and that plan must be communicated to the doctor, what you want to achieve out of that 10 to 30 mins of the doctor time you have paid for.

Before you go, think about all the symptoms.

Pick the one you are most concerned about (what about the others you ask, don't worry you will get to them)

For that symptom, you are most concerned about, think about it, how long ago has it started, where is it located

Has it changed postion, is it moving to another part of the body or do you feel similar things in other part of the body. What has changed about the symptoms since it started, is it better, is it worse or has it remain the same, are there times, this symptom let you be fine

What did you don at that period. How are you different now from the "normal" you. What are the possible things that may have contributed either positively or negatively to this symptom

What have you done so far on you own about it, have you tried treating yourself and with what. Is this the first time you experiencing this symptoms, have you experienced it before and what you did about it (even if you went to eléwé ọmọ, or your pastor prayed for you, SAY IT)

What particularly about this symptom has made you decide to see a doctor. What are you hoping to achieve from this consultation (I will talk more on that along the line)

When telling the doctor all this, try to be specific as possible (use minutes, hours if possible. Try to state the time if you remember them)

By the time, you have given your doctor this story... You would have provided him with his most powerful weapon. THE HISTORY OF PRESENTING COMPLAINTS.

If you are a new patient, the doctor will most likely want to know about your past medical history. For this, I advise you divide it into 2
a) any recent illness (within a month) that bears similarities with your present complaint, what the diagnosis was, what investigations done

what treatment was offered, are you still on that treatment, what are the names of the drugs, are you taken them as prescribed or you missing out.

b) Major organ illness like Asthma, Epilepsy, Diabetes, Heart disease e.g. Heart Attack/Failure, Liver Failure, Kidney dis/Failure

Hypertension, Hepatitis, HIV, Migraine, Ulcers, Arthritis, Stroke, Cancer etc
It is best to state when this diagnosis were made, if you are seeing a doctor about them or not, if you are on any medication for them and how stable you are.

All surgeries should also be stated.
You should also tell your doctor any medication you are taking regularly and what they are for, the dosages and how often you use them. Best if you can even bring them to the hospital with you.

You should also avail your doctor what you daily life is like, your social life, what you do for a living ( you see some jobs are risk factor for certain diseases). Smoking and alcohol history (don't lie about this😂😂🤣)

It is also a good thing to state your ideas (including what Dr. Google has told you), concerns and expectations.
Your expectations might be modified your doctor.
I means, 6 months headache and you expecting cure. I'll modify it to understanding why you having persistent headache

So next time you go to your doctor... Be prepared for that consultation, have story prepared and your question ready. You will realise the satisfaction you derive from having a fruitful conversation. And you would have provided your doctor with his a powerful tool. YOUR HISTORY.

And to let you know why your history is important.

When a doctor gets a diagnosis wrong... He goes back to the basic.... YOUR HISTORY. THE DIAGNOSIS IS ALWAYS IN THE HISTORY