How to get the best out of your doctor

By on July 29, 2011
Photo © Elena Derevtsova
From time to time I get e-mails or phone calls from members of the public along these lines: ‘I need a so-and-so test – how much does it cost?’
Are they expecting the response will be: ‘The price is ¥…Roll up your sleeve and we’ll take a blood sample…Now see the cashier on your way out and call for the result tomorrow. Next please!’?
Patients who approach doctors in this way are not usually well served. I have known some who say straight out, ‘I don’t need a consultation, I just need a so-and-so test.’ Such people are not acting in their own best interests.
Often, patients have done an Internet search on their symptoms and diagnosed themselves as suffering from X disease for which there is a confirmatory test which they think they need. They then go shopping around for the cheapest price.
While I am all in favour of patients being fully informed about their illnesses and treatment, I would not recommend the Internet as the best place to start. People who do this are unlikely to find reassurance; instead they become anxious, sometimes very anxious.
A typical scenario is someone thinks they have run a risk of getting HIV infection and has then coincidentally developed symptoms which, from surfing the Internet, they are convinced mean they have contracted a dread disease. The problem is that many symptoms are common to many diseases and it is almost impossible to diagnose oneself by looking up symptoms. HIV tests need to be conducted in the light of all the circumstances, including the type of risk someone thinks they may have run, the time
since possible exposure, and other factors. Having said that, I would never decline to do a test if a patient strongly wished to have it, within reason, even if I thought it was unnecessary.  
Another example which I met recently was in the form of an e-mail, shortly followed by a phone call, from a medical insurance company who wanted to know urgently if I could arrange a ‘thyroid scan’ for some of their clients who possibly had been exposed to radiation near the Fukushima nuclear power plant. I tried to explain that I would need to obtain full information about the type and duration of exposure, whether they had symptoms, whether they had taken potassium iodide, etc., and then decide what, if anything, should be done.  
That is not say that patients may not have sensible ideas about their problems. Often they do, and I am always glad to discuss patients’ own views on their illnesses during the course of a consultation. Doing tests in isolation can be misleading. There may be false positives and false negatives, and in tests with a numerical result, slight deviations from the normal range do not necessarily mean something is wrong. To get useful information from tests it is essential that the results are interpreted in the context of the patient’s overall situation.
Your doctor is, or should be, a ‘highly trained professional’, who has the background knowledge and experience to judge what tests, if any, are appropriate in the circumstances.  
To get the best out of your doctor, therefore, it is important to keep in mind that you are seeking an opinion about your symptoms or health concerns, and then to be guided by the doctor as to how to proceed.
Dr Gabriel Symonds runs the Tokyo British Clinic and has had long experience of the health concerns of the expatriate community. Full medical services are provided including HIV tests. Tel: 03-5458-6099

About Dr. Gabriel Symonds

Dr. Gabriel Symonds was the director of the Tokyo British Clinic. The clinic closed down in May 2014 after serving the expatriate community for 20+ years. Dr. Symonds has retired and the Tokyo British Clinic is now closed. Dr Symonds will continue to live in Tokyo and may be contacted by e-mail over any questions concerning medical records or related matters: He will be available from another address for: smoking cessation psychotherapy/counselling circumcision information Tel: (03) 5458-6099