Listen to me, Doc

I know my doctor, Anthony "The Probe" Armageddon, doesn't listen to half of what I say. Heck, I don't listen to half of what the voices in my head say when I'm in his office.

Danielle Ofri, an internist at New York City’s Bellevue Hospital and author of Medicine in Translation: Journeys with my Patients, gives us some insight into doctor hearing.

Doctors have always filtered patients’ words. Some of this is the result of the historical difference in lay versus medical language. A patient may say that she had trouble breathing, though did not cough up any blood. The doctor would then write that “the patient admitted to dyspnea, but denied hemoptysis.”


Doctors often prioritize patients’ symptoms differently from the way patients do. A patient may be most concerned about a painful ingrown toenail, but the doctor may focus on the anginal symptoms of chest pain instead.

And then doctors may—diplomatically or not—casually toss some patients’ concerns aside entirely. I have been guilty of this myself. I have some patients who seem to stockpile hordes of complaints for me, unloading them in heaps during our 15-minute visit. I listen and nod, but choose not to enter into the medical record the ones that seem clinically insignificant.  This stems from both the reality of the time crunch, and my clinical experience that most of these minor aches and pains are self-resolving.

Maybe she's doing a disservice to her patients by acting as a filter, she says.

A growing body of evidence suggests that the gap between what patients say and what doctors document can be ample. Patients often report symptoms much earlier than did doctors. Several studies have shown that patients’ report of symptoms correlate more accurately to actual health status than did the doctors’ reports.


for regular medical visits, perhaps there could be a section of the computerized medical record for the patients to access directly to list all concerns. This would be a legitimate part of the record, and then I would have my part in which I’d place my clinical impressions of these symptoms.


Seems like a good idea to me. I bet that we’d uncover many more side effects sooner. It would also remind us, that doctors need to view patients’ words as primary data, and that we should be careful about filtering the patient’s voice too much.

Maybe, just maybe the patient knows something about his or her body ... nah.