Conflicting diagnosis. What to do when you disagree?

This article was originally written after a personal experience we had with our daughter.  It took 3 visits in 21 hours to be allowed a referral to the pediatric surgeons at the main hospital ER although she had a “surgical abdomen”.  It was a most unpleasant experience to say the least.  The most common response I have gotten whenever I relay the story is “How can anyone get their child’s needs met if I couldn’t.”

While this article is written to help parents deal with when their children are given a diagnosis they don’t agree with,  it is applicable to adults as well. So please read on.  I am creating an informational video about our daughter’s particular diagnosis.  It is my first time editing a video so it might be a couple more weeks.  I captured the video because her symptoms were initially occurring only every 40 minutes so that I could document the severity of pain. Now onto the article.

Conflicting Diagnosis

As a parent there is nothing worse than having a sick child.  This is amplified if you are in the position of conflicting opinions and or you don’t agree with the diagnosis.

Establish a relationship

Having an established physician will help facilitate minimizing the above.  The trust from an established relationship is what you can rely on when symptoms lead to an uncertain diagnosis.  If you are having trouble finding a good doctor, you can get more information here.  You can also find more about getting your needs met within the doctor’s office here.

The best way to find a doctor is word of mouth. Like attracts like.  When patients say that a doctor is good or bad, often times what they refer to as good and bad is communication styles (otherwise known as bedside manner) as being good or bad.

Interview the doctor first even if it requires a one-time visit.  Although some offices extend “meet and greets” as a free service to patients, others don’t.

Trust your instinct

What if your concerns about your sick child fall on deaf ears? For example In the case of an emergency when you may not be dealing with the doctor you know and trust.  The number one thing I tell my patients is to trust their instinct.   If you don’t agree with what the doctor is proposing as a diagnosis: say so.  For example, they think your child’s severe abdominal pain is due to constipation but you feel it is something more serious like appendicitis.

Here is some sample dialogue to help you can communicate: “I feel like we are missing something more serious.”  And then state what diagnosis you feel is being missed if you know.  Many a times a parent’s cause for concern is spot on.  They know their child best.

For example, my daughter has a very high pain tolerance rarely crying including when she sustained a fracture.  If she cries from pain, then I know there is something significant causing her pain.  Parental instinct is why I will always ask:  “What do you think is wrong?” if I sense the parents don’t agree with the diagnosis.

Here is some additional dialogue if your concerns remain unaddressed:  “Can you be certain that it isn’t something more serious?  When should I bring my child back in if he is not improving?  What will be the next step in the evaluation if he is not improving? Wouldn’t it be prudent to observe my child to ensure this isn’t something more serious?”

Be Assertive

Sometimes early in the onset of an illness, the diagnosis is not clear.  For example in appendicitis, the symptoms may not point to the diagnosis at the onset.  Over time the symptoms will point to the diagnosis.   If your child’s symptoms are increasing and are still not being addressed:  be assertive.  You have to be the advocate for your child.

Too many patients will not vocalize their concerns over the fear that they may offend.  I have even seen patients stay with doctors they don’t even like for years.  It is your right to have the health care you deserve.  Do not worry about offending.

Seek a 2^nd or 3^rd opinion

In medicine there is often times more than one-way to treat a condition: one antibiotic over another, open surgery vs. laparoscopic and so on.  There will be risks vs. benefits for each treatment.  Most doctors will usually have a strong opinion about one treatment over another.  If they don’t have a strong opinion, ask, “What would you do?”  Just remember the doctor may put the decision back in your court, as they cannot make decisions for patients.

If there is uncertainty, then seek a 2^nd opinion. If you still don’t agree, then seek a third opinion.  A third opinion is rarely necessary but if there is continued uncertainty it may help resolve the diagnostic issue. Remind yourself; you deserve the right to the best health care for you and your children.  Any good doctor would agree!