As I noted yesterday and in other posts, never be the first, neither be the last, when it comes to new medications & techniques. |
Never? Well, never say never, but I suspect that if you're presenting with common symptoms which all point towards a common diagnose, and you respond well & quickly to common treatment modality, chances are pretty good that we (you & I) got it right. Sure, we may have to adjust the dose a little up or down. Perhaps we'll need to change the medication entirely while staying within the same class (kind of like switching from Chevy to Dodge to Ford). But the point is that you're getting better.
But what if your symptoms don't clearly point to a single diagnosis? What if the tests are equivocal? What if you don't respond as expected to the initial regimen, nor the succeeding ones either? What if your symptoms (and tests) point to a diagnosis with greater potential for loss requiring major intervention, eg surgery, radiation or chemotherapy? That's when I think it's perfectly reasonable to consult someone at a major teaching & research facility for a second opinion. After all, these guys in the ivory tower fashion their careers around finding zebras when they hear hoof beats. Those of us in primary care mostly find horses when we hear hoof beats.
And what of the residents? Family medicine is all about developing relationships with your patients. It's all about listening closely to what they're saying (and not saying). It's following up closely so that if the patient doesn't respond as expected, we help expedite their search for a second and even a third opinion.
But here's where health care is a two-way street. You have to be open to us (your family physician). You have to tell us everything. You have to follow through with our recommendations or explain why you couldn't. You have to keep your follow up appointments with us so that we can monitor how you're coming along. Remember that your health requires a team effort.