Just the Facts, Please

I might have titled this, Just Answer the Question, but at any rate it can be surprisingly hard to get people to give you the information you want/need as opposed to what they think you need or want you to know.

This comes into sharp focus when I am getting ready to do an EMG. This is not a situation where I need a detailed medical history, it's really what called a "problem-focused" evaluation, revolving around the question of why this test has been ordered. Beyond that, I have to decide what is a reasonable list of things to consider based on my own history, not just relying on the referral slip that says, "possible carpal tunnel syndrome."

So after introducing myself, I ask, "What symptoms are you having?" It seems more often than not the answer will be something like, "My doctor thinks I have a pinched nerve," or "I have some bulging disks." Not symptoms at all, but tentative diagnoses, or related findings from other tests.

So I repeat the question, or rephrase it, trying to get to the problems they were having that led to them going to the doctor. So then I might hear something like, "Well, I was talking to some people at work and they thought I might have carpal tunnel syndrome." Great, very helpful.

Eventually, I can usually get to some sense of the subjective problem they are having, stripped of all assessments, all references to family members that had the "same thing" and other such relatively irrelevant stuff. But sometimes I have to just give up and go with what terse and sketchy information I have on the referral papers. I just don't have an hour to spend on getting a history for this purpose.