Saturday, 11 February 2017
PATIENT AND INVESTIGATIONS
When a doctor wants to treat a patient, it must know the disease and hence needs to make a diagnosis. In many cases the diagnosis can be made on clinical grounds with relevant investigations to confirm it. In many cases a differential diagnosis has to be made and the possibilities confirmed again by relevant investigations.
But in many countries with very high populations like India and China, there is lot of pressure on the health care system. Doctors have much lesser time to the patient than in less populated countries. Diagnosis has to be made in a short time. For this I am giving the following scheme to make a quick and relevant diagnosis.
A pre prepared form should be attached to each patient with space for name, age, gender, short clinical history, relevant positive physical findings and investigations to be done.
What this will do is to save time and the investigator (Biochemist or Radiologist or Pathologist) can investigate and concentrate on the most important factors. This will make the diagnosis truer and more clinical.
To give an example, in a case of suspected pulmonary Koch’s the form or card should read as:
Name Age Gender
History: Cough 1 month, fever 1 and half months
Physical Examination: Bilateral crepitation in apical region
The card can be in multiple so that each investigator receives one card with the investigation asked for. In the above example the card can be in triplicate, one sent for X ray to the radiologist so he/she can focus on the apical region in X ray. One to the Microbiologist for sputum for AFB. One to the biochemist for ELISA for TB.
Thus a small card can make the diagnosis easier and can be confirmed by biochemist, radiologist and microbiologist.
This is a good way to remove the pressure on the overworked investigators and doctors and will help in a quicker diagnosis. The diagnosis will be more relevant and treatment and management of patient more clinical and easier.
Copyright © Tanvir Nebuchadnezar
Labels: how to combine clinical data with patient investigations to help in diagnosis, Investigations in patient management