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Never Settle For Over-The-Phone Diagnoses!

It was raining. Pouring. Freezing. But nobody had moved.

We were outside on that field, my friends and I, paying our respects and watching with heavy hearts as the coffin was being lowered into the ground...

Very dark clouds gathered to mourn with us in heavy downpour, masking our tears.

The time was 5:00pm.

We were about to turn and leave when suddenly, Reid, one of my friends, broke out in a fresh wave of tears:

“What have I done!” he wailed, as we scrambled to get him out of the suspicious glare of other drenched and grieving friends and relatives of the deceased…

“Oh, what have I done…!” he kept repeating over and over for another agonizing few minutes.

“Well then, what have you done?” I finally asked.

Now very pale, he looked at me: “I can’t believe Fran is dead! She phoned me in the evening just two days ago and complained about some vague chest pain she’d been having since a few hours before then. She said it was like an ache in the middle of her chest and it made her feel nauseous. I had been on-call at the clinic and was so tired then, so I just instructed her to go take some paracetamol and get some sleep, assuring her that it would all go awayHer sister rang me that midnight to tell me that Fran had died! I was shocked! They immediately had an autopsy done, and the coroner announced to her family that Fran had died of a heart attackA heart attack? And then it dawned on me: Fran was 50 years old, diabetic, and rather overweight. She actually was at risk of a heart attack! What was I thinking? What if I had invited her over to the clinic that day? What if I had simply taken time to go see her and get her examined promptly? We could have done an EKG and other tests! Wouldn’t she still have been with us today? How irresponsible I was…!”

Reid was now shaking and weeping uncontrollably, and there was nothing that any of us could say.

 

Fran Was Just One of Many

Sometimes, a mild and bearable symptom may be a warning sign of a huge tidal wave coming in the horizon.

heart attack-what we call a Myocardial Infarction- may present with chest pain that spreads to the neck, shoulder or back; profuse sweating; and nausea among other symptoms. But not so in diabetics. In diabetics, elderly people and few other situations, a serious condition like a heart attack may not present with typical chest pain. Many times, they only feel a slight chest discomfort, which is usually ignored until disaster strikes.

This kind of heart attack in diabetics is called a Silent Myocardial Infarction, or for short, a Silent M.I.

 

Over-The-Phone Diagnosis

It’s ok to talk to your doctor over the phone, but diagnoses and certain drug prescriptions should never be made like this- except you’re stranded on a lonely island 80,000miles from any hospital!

Phone consultations are indeed useful for discussing test results and administering regular repeat prescriptions. Otherwise, these consultations should be highly controlled, and even more stringently so in developing countries like Nigeria where I’m writing from today. 

Misdiagnosis and other medical errors are now in the top ten causes of death in many countries all over the world.

 

Dear Doctor…

Be alert during phone consultations to reduce the risk of missing out or misinterpreting useful information.

Get a recording app or other forms of effective documentation for your consultation sessions.

Try as much as possible to not give definitive diagnoses and one-time treatments over the phone unless they are necessary. Imagine announcing a diagnosis of cancer over the phone, only to be informed barely an hour later that your client has committed suicide! Things could have been by far better if you had looked in his eyes, held his hand and personally talked him through!

 

Dear Client…

Feel free to ring your doctor apart from the Ambulance Service in an emergency.

Please do not insist on getting a diagnosis over the phone.

It is not safe to get antibiotics prescriptions over the phone!

If you must call a doctor, do try to ensure a face-to-face visit afterwards, as soon as possible.

So, let’s be careful, friends. No short-cuts if you can help it.

Face-to-face consultations are the best, and this way there will be less chances of misdiagnosis…and less heartbreaks!

Cheers! Enjoy a great week!

-Okikiolu.
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