事件记录
史考特: How do you tell your doctor what's wrong with you when you can't even yourself really put words to it and communicate what it is? We'll give you some pointers on what you can do so you can get better next on 范围.
播音员: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. 您正在收听的是范围.
史考特: Dr. Miller I have a feeling that there are a lot of patients out there that maybe aren't feeling 100%. 他们不健康，但他们真的无法描述自己的症状.
Dr. 米勒: 但他们对此很担心.
史考特: 但是他们很担心，或者他们只是想感觉好一点. 正确的?
Dr. 米勒: 你知道，这不是一两天就会发生的事情, 但也许已经持续了好几个星期了.
史考特: 是的，但是他们害怕. 就像你去修车一样. By the time you get to the doctor the auto mechanic is going to have to start throwing parts at the problem.
Dr. 米勒: It's a little bit overwhelming to come to the doctor's office and enter this large medical system where many things might happen.
史考特: 是的, and then we're afraid you're going to start throwing tests at this problem and we're never going to find out what's wrong.
Dr. 米勒: 我认为这阻碍了人们去看医生. So in reality, Scott, many times the diagnosis can be arrived at through a history and a physical.
史考特: 即使我只是有些模糊的症状?
Dr. 米勒: 绝对. And I think some people believe that rightly or wrongly they will need imaging. So a CT scan or an MRI or they'll need a lot of blood work or they'll have to get onto a treadmill. 他们可能认为测试会给他们答案. 但事实并非如此. 至少一开始是这样.
史考特: 好吧.
Dr. 米勒: 另一部分是, 或者在它的另一边, patients might not want to do that because they don't have the funding to do that. They don't have the money to do that and so they're afraid that the physician is going to order many tests that they can't afford and that will just confuse things even more for them. 他们只想要坦率的谈话.
史考特: They want straight talk and then want to feel better and they don't want to have to take a lot of pills or do a lot of tests or come back to your office eight times.
Dr. 米勒: 正确的. 所以有两个阵营. One camp of patients might want testing that they think will make them better when in fact they don't need specific testing. 他们需要有良好的病史和体检. And the other set of patients might eventually need testing but they are worried at the get go you're going to run up a whole bunch of bills performing tests. 这也是不对的. 首先是病史和体检.
史考特: That's your first line when somebody comes to you with this sort of a problem, 你开始研究历史. 以及如何?
Dr. 米勒: It's an age old approach to taking care of illness and it's still the best way to do it.
史考特: 以及如何?
Dr. 米勒: 这绝对是最好的方法.
史考特: 你有多少次仅仅从第一步就知道发生了什么?
Dr. 米勒: Probably 90% of the time we'll figure out what's going on or you'll have a general idea. You can create broad categories of diagnoses and those can be sorted out usually within the first visit for the patient by taking an adequate history.
史考特: 所以你做历史. 那10%没用的人怎么办? 那时会发生什么?
Dr. 米勒: 那要看你查到什么了. 这有点难解决. But I think the message here is that patients coming into the office will have some type of an answer by the end of the examination and then a more focused approach to what testing will be needed. 大多数情况下，测试并不广泛.
史考特: 是的. 你有没有遇到过无法解决问题的案子?
Dr. 米勒: 确定. 确定. 这需要一段时间，有时你不明白. 这是罕见的. 这种情况并不常见. In general when you can't figure it out or put a name to it, the patient continues to do well. They may have complaints but in general it isn't a life threatening or chronic condition for them.
史考特: 所以你可以松一口气了.
Dr. 米勒: 他们可以，我也可以，只要你把门打开，他们就会不断回来. If reassurance is important for them then that is an important thing to provide. Reassurance is a very effective treatment sometimes even when you can't find a diagnosis. 但是你可以说，“我不认为这会导致什么可怕的事情."
史考特: Is there something that the patient can do before they come to visit you for that first time to prepare for that kind of history probing that you're going to do?
Dr. 米勒: Well we talked about this in another interview and I think that main thing for them is to write down a set of questions before they get to the doctor's office because many times patients sort of lose their words by the time they get in to see the doctor. They are a little bit anxious and they don't remember all the questions that they wanted to ask. 所以在问题出现之前把它们写下来是很重要的.
史考特: 这些特定的症状?
Dr. 米勒: 正确的 and sometimes bringing a family member to double check what they are seeing and thinking. 尤其是对老年病人来说，这可能很有大发娱乐. Especially if there's issues of memory and forgetfulness associated with how they're acting and feeling.
史考特: 所以底线是. If somebody is not feeling well they really should just come to see you because odds are you're going to be able to figure it out in that one visit.
Dr. 米勒: 正确的, they should be able to go and see a primary care physician or a provider who provides primary care and ask questions. Spend some time having a physical and history and that's the beginning of the process of learning what is going on. I would say the majority of times, it's not usually something that is seriously wrong.
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