'Today's doctors can't see a doctor without a machine'! How many doctors have been hurt by this statement

"As soon as you come to see a doctor, you say that you need to do an examination. Do your doctors know how to see a doctor without equipment!"

In the outpatient clinic, a male patient accused Dr. Chen angrily, with an agitated tone, because Dr. Chen wanted him to undergo a CT examination for further diagnosis.

In less than half a minute, several onlookers gathered at the door, discussing in low voices:

"The doctor asked me to draw blood just now."

"It's just a headache, why do you need a CT?"

Doctor Chen sighed helplessly, he was used to this kind of scene . In Dr. Chen's opinion, both diagnosis and treatment must be based on evidence, not based on feeling and experience. Instrument inspection can help doctors clarify the condition and formulate a reasonable treatment plan.

1. Why do you often do check-ups when you see a doctor?

Laboratory tests, color Doppler ultrasound, MRI, CT... Now when you go to the hospital to see a doctor, many patients need to be checked, but some people are very resistant, thinking that they have been "trapped".

In response to this problem, a doctor shared a bloody case.

Last year, a young man in his 20s came to see a doctor. He had had stomach distension, stomach pain, and acid reflux for more than two months, and he couldn't bear it anymore. In the outpatient clinic, after the doctor gave him a preliminary examination, he suggested a gastroscopy, but the young man refused as soon as he heard it .

There is no way, without an examination, the doctor can only prescribe the right medicine.

Half a year later, the young man's symptoms reappeared and aggravated, and he came to the hospital again. The doctor gave him ideological work and advised him to have a gastroscopy. He sighed and reluctantly agreed. The results showed that the stomach wall was stiff, and there was redness, swelling and ulceration in the antrum of the stomach, and the biopsy was diagnosed as " gastric signet ring cell carcinoma " . Follow-up examinations found that the cancer had metastasized to the abdominal cavity, which was at an advanced stage.

Half a year is enough for gastric cancer to develop into an advanced stage. If a gastroscopy is performed at the beginning, will the outcome be different?

There are too many unknown risks in medicine. Doctors are human beings, not gods. It is impossible to know what is going on in a patient's body at a glance. The doctor's judgment is subjective, but the diagnosis needs objective basis to prove its scientificity, and sometimes instrumental examination is essential.

2. Without the equipment, will the doctor still see a doctor?

"Without the equipment, will your doctors still see patients?"

Countless patients have asked this sentence, so let's assume that if the hospital has a power outage and all the instruments are unusable, what should we do?

Before the popularization of laboratory examination and imaging technology, traditional physical diagnosis occupied the main position . Physical diagnosis refers to physical examination . Through physical examination, combined with consultation, most common diseases can be diagnosed. It is not that doctors will not see a doctor without equipment.

What's more, diseases are divided into serious diseases and minor diseases, most of which do not need to be checked . For some common diseases, most doctors will not ask patients for further examinations, so in community hospitals, there are relatively few cases where instrumental examinations are required. People who go to large hospitals to see a doctor may have diseases that cannot be diagnosed or treated by community hospitals. At this time, the probability of examination will increase.

Objectively speaking, instrument inspection is the result of medical progress.

Taking cerebral hemorrhage as an example, if the patient has suspected symptoms, CT examination can quickly assist in the diagnosis. But if there is no CT, the diagnosis process is traditional and cumbersome , requiring repeated physical examinations, experimental medications, lumbar punctures, ventriculocentesis, etc., and it takes several days.

Cerebral hemorrhage is a critical disease, and every minute of treatment every night increases the risk of death.

Therefore, if there is no equipment, the doctor will also see a doctor, especially for minor diseases. However, if it is an intractable or serious disease, it may increase the probability of misdiagnosis and time cost, and eventually delay treatment.

3. A doctor who is good at using instruments is a good doctor

In fact, the purpose of medical examination is very simple, one is to verify the doctor's judgment, and the other is for further treatment.

In modern medicine, a doctor who is good at using instruments is a good doctor and a doctor who is responsible for patients. Judging whether different patients need to be checked, what kind of tests are needed, and when they need to be rechecked are the basic skills of being a good doctor. After all, experience can never replace real data .

Of course, we do not encourage any excessive examination and treatment, but both doctors and patients should actively consider necessary examination and treatment.

Extension: Physical examination detects these diseases, basically no treatment

Sometimes, when patients find abnormalities during the examination, they are frightened and even think that they are going to die. In fact, we don’t need to worry too much about some problems found during the physical examination, because they basically don’t need to be treated, such as:

1. Cervical erosion

The words " cervical erosion " sound scary, but it is not really erosion, but a very common chronic cervical inflammation, most of which are normal physiological phenomena and do not need treatment.

2. Premature heartbeat

Premature heart beats are the most common type of arrhythmia, where the heart beats prematurely. But it is not a heart disease, the vast majority are benign and will not cause heart problems, as long as there are no other abnormal symptoms, there is no need to worry too much.

3. Chronic superficial gastritis

Most people who have undergone gastroscopy will get the conclusion of " chronic superficial gastritis ". This is the mildest diagnosis and usually requires no treatment if there are no symptoms and only mild inflammation.

4. Asymptomatic prostate calcification

Prostate calcification refers to the deposition of calcium salts in local tissues , which is a symptom, not a disease. In most cases, prostate calcification is a normal physiological process, generally without obvious symptoms and signs, will not affect fertility, will not cause cancer, and does not require targeted treatment.

The reason why medicine continues to develop is to give faster and more accurate diagnoses, race against diseases, and win lives. We should look at medicine from a scientific perspective, neither over-examine nor blindly reject it, and we must think twice about every step in the face of disease in order to seek the highest benefit for patients.

References:

[1] Cai Shishi, Xu Ying. When a doctor sees a doctor, clinical thinking is more important than instrument inspection——An interview with Li Yousheng, director of general surgery at the Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine [J]. Rehabilitation, 2017(5): 3.

[2] General practice room · case6 | Emphasis on the basic skills of physical examination. Department of General Medicine, First Hospital of Zhejiang University. 2019-10-25

[3] There is basically no need to treat these 9 diseases found in the physical examination, so don't scare yourself! .Medical Endocrinology Channel. 2020-01-07

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