Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

What's in a Diagnosis?

itsalongwalk2iitsalongwalk2 Posts: 15
edited 06/11/2012 - 8:47 AM in Chronic Pain
I was wondering how many of us have struggled to get a diagnosis from our doctors?

I think the reasons for this are many - some wait and see which is all well and good in some cases but I also think some poor patients are overlooked in the medical world simply because of the way that the doctors write up the diagnosis.

I think that some of our conditions overlap - there are several way to write them up. For example one doc may say DDD and another may be more specific and say annular tears.

The question is do the supporting team behave any differently and help the patients in a more pro active way if the diagnosis are different? Pain can't be measured on a definitive scale. A person coping better doesn't mean they are in less pain - just coping better.

I get really frustrated when I think about this, knowing some of us are being side stepped and others seem to have intervention after intervention with no real end game.

Is is down to the perceived diagnosis I wonder?



  • jlrfryejjlrfrye ohioPosts: 1,110
    I used to do medical billing and the doctors are just playing the insurance game. A procedure may be covered with the diagnosis ddd and not annular tear or vise versa. The phy. will use the diagnosis that best fits for the procedure to be paid by ins. Even though you have different diagnosis the doctor has to bill the diagnosis that goes with the procedure. Its a insurance game between the docs and the insurance company. You may have 4 different diagnosis codes but one may not be allowed by the insurance company. So that diagnosis will not be billed.
  • Itsalongwalk,

    I too have felt similar. With some it is easy as they only have one primary issue going on. When you start adding more and more issues, the picture starts getting foggy - that is driving me nuts presently. I've had doctors who look at one area only to ignore the others. I've had doctors who look at the whole mess and now want to find the one commonality to all of them to form a "true" (yeah right) diagnosis.

    Flip the coin, my own NS told me similar to what jlrfrye brought up. I was given a prescription for a pre-op chest x-ray, and the "diagnosis" on it was persistent cough! I looked at it and said "I don't have a persistent cough", and he came back with "We have to that that sometimes due to insurance. There are some procedures we know are needed, but they won't cover it for xx, but will for xx." Ridiculous if you ask me. The doctors are the experts, NOT the bloody insurance companies. Oh, but they "have" the big bucks vs make the big bucks. Gotcha.. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • A very good point, and I think these forums exist largely for this reason alone.
    How good would it be to be able to go to one medical centre where ALL aspects of the body and the patient are studied, so that nothing relevant is omitted.
    So many of the medical fraternity consider only what is within their realm, and don't suggest other avenues to explore.
    My case for instance:
    Troubled with chronic pain ,headaches, RSI etc for over 20 years, made much worse by my work which was all computer input.
    My old GP suggested a muscle relaxant, and he was probably on the right track. My wife warned me of the side effects so I stopped taking it immediately.
    After early retirement I applied for disability. My GP diagnosed a worn out neck, but sent me to a rheumatologist to get a specialist opinion for my claim.
    He diagnosed arthritis, and referred me to a rehabilitation expert to see what my job prospects were.
    This doctor said I was unable to be rehabilitated, as my condition was irreversible. I then received the pension.
    The pain was getting me down so I asked my GP for advice, and suggested a pain doctor.
    This doctor listened to my symptoms (no examination) and suggested steroidal injections.
    I subsequently had 9 sets of these over 3 years, for partial and temporary relief.
    He retired, so I went to a new pain doctor.
    Surprise-he was the first one to physically examine me!
    He said that my neck muscles were all very tight, and would have been causing my headaches.He said my arthritis didn't appear to be bad enough to cause my pain
    He sent me to a clinical physio who gave me a series of stretches and exercises, and said that remedial massage was an essential treatment.
    This all worked a treat and very soon my pain was under control. It always returned but I was able to get things done again.My masseuse explained how tight and knotted my muscles were, and she was able to gradually get them calmed down.
    I needed massage every 2-3 weeks at least.
    I would tell my GP about the benefits of this massage, and he would give me a 'look,' and said my neck is worn out and nothing will fix it. Anyway, I kept telling him at every visit.
    Then, a few months ago, my daughter suggested that I try taking magnesium oil and vitamin D for my pain. She researches these sorts of things in relation to her own illness.
    Within a week or so I thought I noticed an improvement, and after a month was sure.
    Now, 3 1/2 months later, there is no doubt that my paid levels and incidence have dropped dramatically.
    From about 8 pain meds a day, I'm down to 3 or 4. I don't get the severe flare-ups that I used to get, and if I overdo it I recover quite quickly.
    So...the original diagnosis of arthritis as the cause of my pain from the first 3 specialists and my GP was simply wrong.
    None actually examined me, they just used their (limited) knowledge to decide.
    The last specialist was the first one to get it right, some 5 years later!
    He didn't go far enough to get to the cause of my muscle ptroblems, but came very close.
    In the end, it seems that deficiencies of magnesium and Vit D were the causes of my muscle problems, and that 'diagnosis' came from my daughter!
    I keep reminding my GP of this success at every visit, so will see if he takes any notice.
  • It's also important to understand that medicine is a science AND an art. The science part of the equation is fairly precise, it's the art part of the equation that separates the good doctors from the bad.
  • I will tell you that doctors treat me differently between seeing the MRI reports and seeing the actual films. Because seeing it in print is one thing, but seeing the films is another thing entirely.

  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Practicing medicine. We are the subjects that they practice on. In some areas of medicine the practice has evolved to near perfection ... Some examples that I can think of would be knee or hip replacements. Whereas 30 years ago these were new and bold procedures, they are now considered rather routine and commonplace. Think of where cardiac surgery has gone in the past 30 - 40 years ... from valvular defects being fatal to being replaced with artificial plastic valves, arteries being replaced or roto - routered out - lasers being used to dissolve cholesterol plaques.

    We have come a long way baby!

    In one of many former lives I worked in "Quality Assurance and Utilization Review" (QA/UR) for one of the nations top HMO's (yes I had joined the dark side) One of my jobs was to question doctors as to why they wanted to get a MRI instead of a CAT scan.
    This was because MRI's were so very new and costly; they are now commonplace and rarely questioned.

    And yes as mentioned above - the computer systems (claims adjudication) are set with payable diagnoses ... bill with a code that is not on the payable list and the claim gets denied.

    Oh the things I've seen ... the stories I could tell
    Many of them I am restricted to discuss to this day because of involvement with the Department of Justice
    (D.O.J.)and/or the Office of the Inspector General (O.I.G.).

    What’s in a diagnosis? Everything!! And just around the corner is ICD10 replacing ICD9 that has been a coding standard for 30+ years .... prepare for even more diagnosis problems!

    Things are about to get even more fun !!!

    Hoping you all are having a pain managable day,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

This discussion has been closed.
Sign In or Register to comment.