The first step for any patient who presents to a health care professional is to receive a diagnosis. The diagnosis will determine the best options to manage the case. The options may include additional tests, and/or provision of care by the doctor, and/or referral to another specialty for co-management of the case.
It is often stated that the history is 80% of the diagnosis. This is a true statement. This is the reason the Soft Tissue Center schedules a new patient for ninety minutes or two hours. An uncomplicated case will typically require one hour for the history and examination. The remaining time is allowed to initiate treatment if it is indicated. By allowing this amount of time, we can greatly enhance the likelihood of an accurate diagnosis.
Additionally, the Soft Tissue Center has earned a reputation for diagnosing complicated cases. A complicated case may be a patient who has been evaluated by multiple physicians but does not yet have a diagnosis, or a diagnosis that accounts for all of the patient’s symptoms. There are several overlapping factors that may keep the diagnosis difficult to derive. Some of these complex cases can take two to four hours to obtain a history and perform clinical examinations of the involved regions. These cases are given a second new patient appointment for the third and/or fourth hours. These patients usually have a collection of imaging reports and images on CD, lab tests, and reports from other physicians. These records are most often reviewed after the history and exam so we can avoid possible bias in the diagnosis from previous opinions. Once the diagnoses are established in these patients, the treatment plan is presented which may include conservative care at our facility and care from other specialties to resolve the pain and symptoms.
There is an expression in health care, “If all you have is a hammer, then everything looks like a nail”. Even the best physicians in each specialty may view a patient’s symptoms through their own perspective and determine the symptoms the patient presents with are being caused by a pathology which is one of the physician’s primary focus. At the Soft Tissue Center, we make every attempt to intellectually step back and allow for common and uncommon pathologies as well as multiple pathologies that may overlap and present a seemingly confusing case.