Assessing your Doctor's Diagnosis

Even if you are willing to faithfully believe in your surgeon’s technical skills (based on his description to you of his own technical prowess), how can you assess his diagnostic skills and his error rate, when even he cannot?

When I am a patient, rather than ask a physician about his error rate, about the closest I can come to assessing a physician’s diagnostic skill prior to an intervention is to ask myself several less direct questions:

  • Do I understand the physician’s explanation of my problem?
  • Do I understand why the intervention should correct the problem?
  • Do I understand what my physician is uncertain about?

For example, I can ask my physician, what will taking this pill specifically accomplish? What will abstaining from caffeine specifically change about my symptoms? What are the trade-offs being taken in a decision to have surgery? (There are always trade-offs!)

If you understand his explanation, it is more likely to be a correct explanation. If he makes predictions about your condition that you can test over time, then you can assess the accuracy of his confidence.

In laryngology you should be able to look at the video recording of your vocal cords and see if what your doctor says is making sense. The function of the larynx is simple in that it functions very much like a mechanical machine. It adheres to the laws of physics. It is a valve that opens and closes. It is a pair of strings that vibrate.

Consequently, most people can understand the mechanics of the vocal cords. An accurate and precise diagnosis can be translated into easy to understand, non-medical terms and is the key to treatment.

Another caveat, if you feel belittled by your doctor for questioning his judgment, beware. If you have to take the explanation of your physician on the basis of faith, telling yourself that you are not as smart as your physician, consider the possibility that the wool is being pulled over your eyes. Curiously, in some instances a doctor bluffs, hiding behind the facade of expertise.