What did you say? Why didn’t you say something earlier?
Human communication is a surreal experience. We have foreign languages that separate us, non-verbal communication that is not observed, music that the performer has not experienced, written word not understood etc. But what confounds me more as a Doctor is how much miscommunication or lack of communication occurs between the patient and the doctor.
Recently, a patient presented with pain over an area that seemed to center on a single front tooth. Exam revealed no cavity, no old filling, no stain, or fractures etc. So what was causing the pain? I questioned her about the history of that area of her mouth. Was she in an auto accident? Bump the door sill? Fall off a skate board? No to all these.
My diagnosis was that the pulp tissue had died for no apparent reason and recommended a Root Canal. (My four decades of practice helped me decipher). When I opened up the pulp chamber there was no bleeding or living tissue.
After the procedure was complete, I told her that the tooth had been dead for at least 18 months. Then she informs me that while working on a patient in her profession the patient struck her face with a fist in that area 18 months ago and that she had taken a day off for the concussion.
Excuse me? Why didn’t you tell me?
This a very common occurrence in the medical field and is called the “Doorknob Phenomenon or Syndrome” The most important question is asked or information given by the patient’s when the Doctor has his hand on the doorknob on his way out.
The responsibility of the poor communication is shared equally by the patient and the doctor. The patient needs to be more forthright about his or her concerns and communicate all pertinent information. The doctor needs to listen more ‘from his heart’. It’s bad enough that we doctors speak another language and are nearly always in a hurry. Only then can the excellent service, that everyone deserves, be given.
The Doctor’s hand was on the doorknob when the patient asked:
“Dr., could the pain be from my boyfriend beating on me?”
Let the examination begin…………