Communicating with the families of patients is an important part of a physician’s duties. The current way in which health care is delivered, especially when the patient is in the hospital, makes this personal communication more difficult. Patients are often cared for by hospitalists who they have never seen before.
The science of medicine has advanced as well, and there can be many complicating factors in many cases. Often when a family member asks “What’s Wrong?” with my (husband, wife, mother, father, etc.) they get a report of a long list of test results, which they usually do not understand and do not know what they suggest. Here is the problem in a nutshell. Defining what laboratory or physiologic abnormalities are present is not the same as making a diagnosis. When I tell a family member that dad’s hemoglobin is low, the response is often “What does that mean?”
A diagnosis is made by taking all of the data, normal and abnormal, and applying something called the Law of Medical Parsimony. In other word, we want to develop a diagnosis that unifies and explains all of the findings. This is no easy task and patients and their families often get caught up in the individual details, which are given to them by physicians and nurses. The day to day changes that may occur, which may be normal, become worrisome. When asking “What’s Wrong?” ask if the test result suggest a specific diagnosis and what can be done to get this particular answer.
