eli5: How do doctors decide wether their patients tell the right location of their pain and how they experience it so that they can make a decision?


eli5: How do doctors decide wether their patients tell the right location of their pain and how they experience it so that they can make a decision?

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They don’t, they just use whatever information you give them and work from there to start a diagnosis.

Having the patient describe the pain is merely a part of diagnosis.

If the Doctor suspects a certain type of injury or condition based on what the patient describes then they can order diagnostics like imaging (X-ray, CT, MRI, Ultrasound, etc) or various tests like Blood analysis or even physical analysis like moving a joint and seeing how the patient reacts.

It’s by combining all of this information and comparing to a known list of conditions and diseases that a Doctor is able to make a diagnosis and then recommend treatment.

If the treatment doesn’t work, then they can try something else.

Well, the doctor will assume that you have no reason to lie; like, why would you say you have a headache when your *stomach* is what’s hurting?

But pain is only ONE indication that there’s a problem, and the doctor will NEVER rely on just pain to make a diagnosis. The doctor always orders more tests, blood samples, x-rays, what have you, and they make their diagnosis based on THAT, not just on what the patient says.

There are two things medical personnel look at when it comes to pain

A Sign (something anyone can see)

And a Symptom (something the patient reports)

Oftentimes they will ask the patient to point to the pain, and ask open ended questions, to avoid influencing an answer.

Certain patient demographics can play into diagnose. Males and Females will often have signs/symptoms when it comes to things like a heart attack, and depending on how someone grows up, can determine how they interact with a medical professional.

I’m a 2nd year med student so I think I’m partially qualified to answer this. We always “trust, but verify.” First step is to talk to the patient, that gives a general idea of what we are working with, and depending on what we get, we can even sometimes diagnose the illness right there because it all comes down to pattern recognition. If the history is unclear, we do some simple physical exam maneuvers (like pushing on your stomach in 3×3 grid to localize pain, lifting your leg straight up to see if it hurts your back, etc). These will almost always narrow down the illness to a handful of choices. If none of these are super conclusive (which doesn’t happen often), we do imaging and lab tests.

In nearly all cases, doctors already know with history and physical exam alone what is wrong with the patient, the remaining tests are just for verification. That’s how doctors in the past have always done their job, done everything by the bedside with no electricity. And that’s sort of still how they are training us these days. We should be able to list top 3 diagnoses just by a 10min conversation and physical exam on the patient, and then do all the advanced testing to double check. I still have 2 more years to go, but I can already pick up some simple symptom patterns.