“What should I do if the doctor is fixated on my ‘chief complaint’? I must have mentioned chest pain to the nurse at some point, because when I finally got to see the doctor, all he wanted to do was ask me questions about my heart. What I was really concerned about was the cough that hadn’t gone away for two weeks, and whether I might have pneumonia!”

The chief complaint may be helpful for doctors to communicate facts to each other, but often runs the risk of replacing your entire story altogether and boxing into a story that isn’t yours. It’s like using a topic sentence to convey the whole of a 300-page book!

Here are four suggestions for making sure that your doctor hears more than your “chief complaint”.

Tip #1:
Use your own words to tell the story. Don’t let someone else put words in your mouth. If what you have is a cough with chest congestion, describe what that feels like. Don’t say you have “chest pain” just because someone else said you did.

Tip #2: Tell your story the way you would to a friend or family member. Include details that are important to you, not just those that you think might be important for the doctor to hear. Allow the doctor to get to know a bit about you by describing your symptoms in terms of how they impact your daily life.

Tip #3: Make sure you communicate what is most worrisome to you. What symptom most concerned you and why? Talk about why that particular issue brought you in on the particular day. This often helps the doctor think outside the box of what she determined ahead of time to be the “chief complaint.”

Tip #4: Start over. If the message is still not getting through, ask to start from the beginning. “I’m not having chest pain—but I have been coughing a lot. Can we start at the beginning at the beginning and talk about my cough?”

Read more:
Table of Contents
Jerry’s Story (excerpt from Chapter 3)
Danielle’s Story (excerpt from Chapter 5)
8 Pillars to Better Diagnosis (excerpt from Chapter 13)
Advice For Patients (excerpts from Chapter 14)

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