No, I will not admit your child and do a “House” on them. This was a question asked to me recently. While on TV, a whole team of doctors can perform test after test on you and get near immediate results, this does not happen in real life. More likely, a single doctor has a load of patients. Specialists are called in when more help is needed. Fairy tale doctors are just that, they are not real.
People become frustrated being undiagnosed and we understand that. But, medicine, no matter how far we innovated it, is still limited. Test results take time and often offer no clues to the underlying problem. The reality is that the medicine Dr. House practices simply does not exist. And sometimes forcing it can lead to bigger problems.
What happens when a test is done that is not really needed? Often it doesn’t help but sometimes it will find something you were not looking for: what we like to call an incidentaloma. While this finding is most likely insignificant, it cannot be ignored. Further tests must be done at greater cost and risk. And usually end up to find an insignificant problem that you were not looking for and does not explain any symptoms. So, while Dr. House may order every test in the book, plus some outside the books as well, this is not the best practice.
While doctors care about our patients, the truth is that we have more than 1. Most of us have many. It is nothing against you personally. Even if we were able to glean results of tests in 1 hour show segments, we simply cannot ignore the rest of our patients. We will give you the answer as quickly as we can, but we cannot forget our other patients either. They want to be diagnosed and treated just as much as you do. So, no, we cannot do a Dr. House and just sit on your case and ignore all others until a diagnosed is reached.
In the real world of medicine, doctors are not a group of super-heroes plotting to save the day. There are whole teams of people involved in the care of patients: nurses, technicians, and so many more that I cannot list so as not to offend anyone by omission. When you seek medical care, you will be treated by this team. It is a team effort. And that team is not just a team of super-docs. Where are all the nurses and other staff on Dr. House? Surely, some of them aided in reaching the diagnosis. I always listen to my nurses. Dr. House should too. Maybe, he won’t chase so many wrong diagnoses before he reaches the right one if he did.
So, don’t ask me to be Dr. House. He does not exist. And if he did, I am smarter than he and care much more about you than he does. To ask me to emulate him is frankly offensive and disregarding the attention and care I already gave you. If you reached the point that you would rather fairy tale medicine and expect to receive it, perhaps the time arrived to change the channel.
Copyright secured by Digiprove © 2016 Linda Girgis, MD, FAAFP
