Follow me into my spine clinic today and learn how I approach the clinical diagnosis process.

In my practice my goal is to figure out problems for patients (i.e diagnose them). In today’s medical world, the time you get as a physician to examine the patient is limited and thus the art of medical practice is being lost. There are two reasons for this. 1. Insurance reimbursements have dropped (meaning we need to see more people to make ends meet) and the administrative burden has increased (we need to spend more time outside of the exam room doing paperwork).

But a third reason is that the sheer amount of data (medical records, images, labs, etc) to review has also increased.

It would be nice if patient’s problems were neat and could be diagnosed in rapid sequence.  We all know things are more complicated than that. Sometimes patients come in with the wrong diagnosis (i.e. it’s not even a spine issue). Sometimes there is no straight forward explanation for their low back pain.

Examining patients takes time. It also requires analysis of vast amounts of data from their medical history, charts, and usually a large portfolio of diagnostic and imaging studies (MRI, CT, X-Rays, PET are just some examples).

In the spine clinic we are often tasked with figuring out where a patient’s pain is coming from. This can be obvious, say, in the case of a fracture, but in other cases it is more subtle. A small, chipped bone spur barely visible on a CT scan, two bones rubbing together that is only visible on one specialty PET scan not even used routinely in the work up of low back pain. Harmonizing these findings with your history and exam into the final diagnosis is what makes the practice of medicine an art, and its what I strive to maintain in my clinic.

In my practice, I am physician and diagnostician and surgeon second. My belief is that every patient is unique, and part of the fun of being a good doctor is getting to know people and diving in deep to their problems to find solutions. I love using an old-school physical exam to diagnose people and keeping the art of medicine alive.

Have a great week!