Medically unexplained symptoms

The right diagnosis is clearly critical, but around half of all symptoms are ‘medically unexplained’ and don’t easily fit into a diagnostic box. Some hospitals spend so much on expensive investigations for chest pain, abdominal pain and headaches with ‘normal’ results that they’ve set up ‘Medically Unexplained Symptoms’ clinics. If you do get an initial diagnosis, it is likely to be wrong 15 percent of the time. That’s not usually negligence, just the way informed guesswork goes. Always ask ‘what else could it be?’ and ‘how would I know?’
The right care also needs the right treatment; but for most diagnoses, there are now a lot of options to choose from. Doctors try to go through all of them – what’s right for one patient may be wrong for another – but sharing complex decisions in a ten-minute consultation is near impossible. Fortunately, most decisions don’t need to be made immediately, many symptoms improve in time and many treatments and screening programmes are surprisingly ineffective. If you just ask: ‘What’s most likely to happen if I just watch and wait?’, the answer is often that you’d live just as long as if you have your life expensively and inconveniently medicalised.

MD Private Eye 1397 24 July 2015