When “no diagnosis” is the best diagnosis

need a diagnosis.001Yes, there are situations when you don’t want to get a diagnosis.

We all know the importance of an accurate diagnosis. When we seek help for a medical problem, we naturally expect to get a diagnosis because we want to get to the bottom of the problem. We want to know what exactly caused our symptoms.

Correct and timely diagnosis saves lives. However, there are situations when “no diagnosis” is the correct diagnosis. Making the diagnosis of “no diagnosis” is very challenging for the doctor, and very difficult to accept for the patients. It is much easier to throw out a medical term just to make everyone happy and that is what happens in most situations when there is no real diagnosis. For the patient, this “thrown out” diagnosis can be a source of significant anxiety and distress.

Modern medicine cannot always explain why humans have aches, pains and other symptoms. Sometimes, aches and pains are the signals that the body gives out when it is in trouble. At other times, aches are pains are just a part of our daily lives. How do we distinguish between the two?

That is the most important question in medical diagnosis. When we don’t feel well, it is important to seek help. The most important reason to seek a diagnosis is to separate the distress signal from the normal aches and pains. Unfortunately, our medical system is very punitive to doctors who really want to speak the truth when it comes to the diagnosis of “no diagnosis”. Our medical coding and billing system rewards doctors that throw out as many diagnoses as they can.

Let’s explore this with a common example. Some symptoms cannot be ignored. Chest pain is one of them. When you seek help for chest pain, the main goal is to make sure you do not have a heart attack or another serious medical emergency. Not all chest pains are medical emergencies but it is hard to know if your chest pain is a medical emergency without a thorough evaluation. In fact, the majority of patients seen for chest pain do not have any identifiable cause for the chest pain despite a comprehensive evaluation. In many such patients, the chest pain could have simply been a part of the normal aches and pains all humans experience in their daily lives. However, many doctors simply give you an alternate diagnosis for your chest pain. Some tell you it is probably from acid reflux and give you strong medicine to suppress your stomach acid. Others tell you that it could be “costochondritis” and prescribe anti-inflammatory medications.

In some cases, you may truly have acid reflux or costochondritis but these diagnoses are “thrown out” so many times simply because it is inconvenient to think that chest pain can be a part of the normal aches and pains. It is an example of the the situation when “no diagnosis” is the best diagnosis.

Unfortunately, our medical system makes us believe that there is no such thing as normal aches and pains. Many people are happy to simply get a diagnosis for any discomfort. No matter how unlikely the diagnosis is, people prefer “a diagnosis” to “no diagnosis”. Making a diagnosis of “no diagnosis” requires special courage.