A (bad) response to medical uncertainty

Mittal, Manoj K MITTAL at EMAIL.CHOP.EDU
Fri Dec 21 22:07:32 UTC 2018


The case quoted in the article is difficult; the other issue is one-sided quotes; I am a little surprised at Dr Graber's quotes as well! I hope that physicians interviewed for such articles are extremely careful in what they say so as not inadvertently push their practicing colleagues under the proverbial bus!


Leaving aside this case, such cases of headache/chest pain/abdominal pain, loss of vision, seizure-like episodes, and yes paralysis mainly among adolescents, but increasingly among younger children as well  have become increasingly common in pediatric EDs. One can provide them with any label-psychogenic/functional/hysterical/conversion, etc. but this is the reality. It is the parents often who have been to multiple providers already and insist on being provided a label.

Physicians know to be careful before labelling any condition as such; in fact I de-bias myself before going into a room to see a patient with such a complaint - to be extra careful in objectively assessing the situation, and not be affected by availability bias.

________________________________
From: David L Meyers <dm0015 at COMCAST.NET>
Sent: Friday, December 21, 2018 4:33:39 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] A (bad) response to medical uncertainty

 Diane O’Leary, a philosopher interested in ethics & medically unexplained symptoms, brought this to my attention today.

Facing medical uncertainty, doctors tell patients it's all in their heads
https://www.cnn.com/2018/12/21/health/medical-uncertainty-diagnosis-afm/index.html

David
David L Meyers, MD FACEP
Listserv Moderator/Board member
Society to Improve Diagnosis in Medicine
http://www.improvediagnosis.org
Save the Date: AusDEM2019, April 28-30, 2019; Melbourne, Australia


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