'Today's doctors will not see a doctor without a machine'! How many doctors have this statement hurt?

"As soon as you see a doctor, you say that you need to have an examination. Does your doctor not see a doctor without equipment!"

In the outpatient clinic, a male patient accused Dr. Chen angrily and excitedly 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, whispering:

"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 view, both diagnosis and treatment must be based on evidence, not just feeling and experience. Instrumental examination can help doctors sort out the condition and formulate a reasonable treatment plan.

1. Why do medical examinations are often done now?

Tests, color Doppler ultrasound, magnetic resonance imaging, CT... Now going to the hospital to see a doctor, many patients need to be checked, but some people are very resistant, thinking that they have been "pitted".

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 been suffering from stomach bloating, stomach pain, and acid regurgitation for more than 2 months. He couldn't take it anymore. In the outpatient clinic, after the doctor gave him a preliminary examination, he suggested a gastroscope check, but the young man refused as soon as he heard it .

No way, without examination, the doctor can only prescribe the right medicine.

Six months later, the young man's symptoms reappeared and worsened, and he came to the hospital again. The doctor gave him ideological work and persuaded him to do a gastroscope, he sighed and reluctantly agreed. The results showed that the stomach wall was stiff, and the gastric antrum was red, swollen and ulcerated. The biopsy was diagnosed as " gastric signet ring cell carcinoma " . Follow-up examinations found that the cancer had metastasized to the abdominal cavity and was at an advanced stage.

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

There are too many unknown risks in medicine. The doctor is a human, not a god, and it is impossible to know the condition of the patient's body at a glance. The doctor's judgment is subjective, and the diagnosis needs an objective basis to prove its scientificity, and sometimes instrumental examination is necessary.

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

"Without the instrument, will your doctor still see a doctor?"

Countless patients have asked this sentence, so let's assume that if the hospital has a power outage and all the equipment can't be used, what should I do?

Before the popularization of laboratory tests and imaging techniques, traditional physical diagnosis occupied a dominant 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 major diseases and minor diseases, most of which do not need to be checked . For some common diseases, most doctors will not allow patients to undergo further examinations, so in community hospitals, there are fewer cases that require instrument examinations. People who go to a large hospital to see a doctor may have a disease that cannot be diagnosed or treated by a community hospital. At this time, the probability of examination is increased.

Objectively speaking, instrumental examination is the result of medical progress.

Taking cerebral hemorrhage as an example, if the patient has suspected symptoms, CT examination can quickly assist the diagnosis. However, if there is no CT, the process of diagnosis is traditional and troublesome , requiring repeated physical examinations, drug trials, lumbar puncture, ventricle puncture, etc., which takes several days.

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

Therefore, if there is no instrument, the doctor will also see the doctor, especially for minor diseases. However, if it is a difficult or serious disease, it may increase the probability of misdiagnosis and time cost, and ultimately 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 the patient. Judging whether different patients need examinations, what examinations are needed, and when reexaminations are required 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: These diseases are detected by physical examination and basically do not need to be treated

Sometimes, when a patient finds an abnormality during the examination, he is frightened, and even thinks he is going to die. In fact, we don't need to worry too much about some of the problems found during the physical examination, because they basically do not need to be treated, such as:

1. Cervical erosion

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

2. Premature heart beat

Premature cardiac beats are the most common type of cardiac arrhythmia, which refers to a condition in which the heart beats prematurely. But it is not a heart disease, the vast majority are benign, do not cause heart problems, as long as there are no other abnormal symptoms, do not worry too much.

3. Chronic superficial gastritis

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

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, there are no obvious symptoms and signs, it will not affect fertility, and it will not cause canceration, so there is no need for targeted treatment.

The reason why medicine continues to develop is to make diagnoses faster and more accurately, race against diseases, and win lives. We must look at medicine from a scientific perspective, neither over-examination nor blindly rejecting it. In the face of disease, we must think twice about every step in order to obtain the highest benefit for the patient.

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 | Pay attention to the basic skills of physical examination. General Medical Department of the First Hospital of Zhejiang University. 2019-10-25

[3] The physical examination found that these 9 diseases basically do not need to be treated, so don't scare yourself! .Medical Endocrinology Channel. 2020-01-07

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