Does
having a good hunch make you a good doctor or are we all so tick-box trained
that we have lost that art. Why is it then that House MD is so popular when the
story line is around the “hunch” of Doctor House?
Fortunately for my friend, her GP
(family physician) has managed to keep that ability.
My
friend was blessed with good health all her life. She seldom sees her GP so
just before last Christmas she turned up because she has been having this funny
headache that the usual OTC pain killers would not
shift.
She
would not have gone to the doctor except the extended family was going on a
skiing holiday.
She
managed to get to the surgery before they close. The receptionist told her that
the doctor was about to leave. She was about to get an appointment for after
Christmas when her doctor came out and was surprised to see my friend.
I have
always told my juniors to be on the look out for situations like this. Life is
strange. Such last minute situations always seem to bring in surprises. One
should always be on the look out for what patient reveal to you as a “perhaps it
is not important”.
Also
any patient that you have not seen for a long time deserves a thorough
examination.
She was
seen immediately.
So no
quick prescription of a stronger pain killer and no “have a nice holiday”
then.
She
took a careful history and did a quick examination including a thorough
neurological examination.
Nothing.
Then
something strange happened. Looking back now, I did wonder if she had spent
sometime at a Neuroligical Unit.
She
asked my friend to count backwards from 100.
My
friend could not manage at 67.
She was
admitted to a regional neurological unit. A scan showed that she had a left
parietal glioma. She still remembered being seen by the neurosurgeon after her
scan at 11 at night:
“We are
taking it out in the morning!”
The
skiing was cancelled but what a story.
This first appeared as:
Best health care: NHS GP & NHS
Specialist
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2 comments:
That's terrible. I hope your friend will recover from this and will feel better soon enough. I just like to point out that a hunch is a hunch, I don't think it's wise to rely on that especially if you are a Doctor.
But my point is the better you are as a doctor, the better yourhunch would be and no guidline or prvotocol would be able to give you that. In golf, someone said the moreI practice the luckier I get.
For cost efficiency, hunch leads youto investigations that are 95% right.
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