Do you know how to see a doctor? You may not think this is a problem at all, but from a doctor’s point of view, it’s a big, big problem. It is no exaggeration to say that not knowing how to see a doctor has become one of the main reasons why it is difficult and expensive to see a doctor. As we all know, the whole process of seeing a doctor includes “self-awareness, diagnosis, treatment” three stages, here to focus on the first two stages of medical know-how, in order to take less detours in the process of medical treatment, less money spent on injustice. Self-perception and physical examination stage I. Diseases with self-conscious symptoms 1. with clear causes: for example: cold after exposure to cold, fracture after trauma, diarrhea after eating unclean things …… 2. without clear causes: for example: the three manifestations of diabetes (drinking, urinating, thirsty), weight loss of malignant tumors, epigastric pain of gastritis, lymphoma Fever …… II. Diseases without special sensation (subclinical) Many diseases do not have obvious clinical symptoms and are often found by chance during physical examination, for example: chronic hepatitis/early liver cirrhosis, old pneumonia/tuberculosis, and most malignant tumors do not have obvious clinical symptoms in early stage. Third, pay attention to physical examination and self-examination: In Shanghai, physical examination has become the majority of the employed population to do every year, unlike seeing a doctor, physical examination must be done in a formal medical examination institution. Regular medical check-ups will arrange the corresponding check-ups according to the characteristics of different diseases in different age groups, and if you have a family history of a certain disease, you must tell them in advance so that the corresponding check-ups can be arranged. It is important to emphasize that medical checkups are only screening and cannot detect all diseases, and there is a certain percentage of missed diagnosis of early tumors. This requires awareness of self-examination and certain professional knowledge, for example, a considerable number of early breast tumors are discovered by patients’ own self-examination. It is difficult to see a doctor in outpatient clinic, first of all, it is difficult to see a specialist in outpatient clinic. After waiting for several days, the patient can get a specialist’s number for a few minutes without any physical examination, while the patient introduces his condition and the specialist writes, often the checklist and prescription are written before the condition is finished. I think to improve the quality of outpatient care, patients still have some work to do: a. How to see the “emergency” or “first consultation / initial consultation” of new patients? 1, hanging which department: very important, for example, elderly patients with epigastric pain, hanging gastroenterology according to gastritis, gastric / duodenal ulcer to see, hanging surgery according to gallstones think, hanging cardiovascular department according to heart attack guess, hanging respiratory department according to pleurisy, pneumonia check, patients are often confused. The first thing you need to do is to ask the doctor, and now the general outpatient halls of tertiary hospitals have this service. 2, the introduction of medical history to be concise and focused: for various reasons, the time of the specialist clinic is never enough, to allow experts to accurately grasp their own condition in the shortest possible time, see the expert before you should clear your mind. [Warm reminder] What must be said, what can be said, what is ready (if the expert asks then answer), be sure to do your homework first. The outpatient doctors are most afraid of patients with unclear expressions, upside down, and unknown focus. 3.What is the difference between “general number” and “specialist number”? General number: The advantage is that it is cheap and easy to get, and the consultation time is relatively long, which is suitable for the first consultation and the diagnosis of clear and easily treatable diseases. Expert number: The advantage is that the specialist has rich knowledge and has a high level of diagnosis and treatment for difficult diseases. The disadvantage is that the cost is higher and the consultation time is shorter. At present, the most headache for doctors is “treating specialist clinics as ordinary clinics”, not to mention whether there are enough resources for specialists and whether they can physically cope with them, without a series of tests to back them up, it is difficult for specialists to play their diagnostic level. The serious shortage of specialists has serious consequences. The first thing you need to do is to hang up the general outpatient clinic, and then selectively hang up the specialist clinic if the treatment effect of the general outpatient clinic is not good after a series of examination results come out. 4.Which specialist’s number: academic specialization, each specialist has a professional focus, you should do an online survey in advance to find the most suitable specialist. Of course, except for emergency medicine. 5, how to hang imaging specialist number: If there are many CT, MRI films, and the size of the lesion evolution can directly explain the good or bad treatment effect, it is best to hang imaging doctor’s number, now the tertiary hospitals, most imaging doctors have a specialist clinic. As the general patient does not know, they can take a long time to consult, so be sure to bring the relevant medical history and previous examination data when you visit. Second, how to “review” old patients? As the saying goes, a long illness becomes a good doctor. However, doctors have three fears about this kind of patients: first, they are afraid of more information; second, they are afraid of patients ordering drugs, doctors and tests; third, they are afraid of half-understanding and pretending to understand. To avoid these problems, patients should pay attention to the following points: 1. Organize the medical history and examination information: chronologically, use concise and common language to print down their conditions in the form of lists or charts, and some laboratory indicators with important diagnostic significance (such as the AFP indicator for liver cancer patients / or people with high risk of liver cancer) should be listed in chronological order, and doctors are willing to receive serious treatment of their patients. 2. Film should be kept well: Never roll up the film of X-ray, CT, MRI and other examinations, which is inconvenient for doctors to see the film. If there are multiple CT and MRI examinations, because there are many films, it is best to indicate the time of the film and the first few examinations on the film with a small sticky paper, so that when presenting the medical history to the doctor, you can provide the information he wants in the fastest and most accurate way according to the doctor’s needs. 3, never conceal medical history: to avoid being guided by the views of the previous doctor, some patients especially prefer to conceal important medical history and test results, not to tell the doctor the previous consultation process, which should not be, the real learned doctors will draw new conclusions from the previous doctor’s consultation process. From a dialectical point of view, “misdiagnosis” definitely exists, and good doctors can only reduce but not eliminate the “misdiagnosis rate”. The following points will help to reduce “misdiagnosis, underdiagnosis and misdiagnosis”: 1. scientific grasp of the timing of the examination: any disease has its own evolutionary pattern, only to a specific stage, a variety of tests are typical performance, such as the familiar acute pancreatitis, amylase elevation is its characteristic laboratory indicators, but if the pancreatic duct is open, pancreatic hypertension is lifted, as long as a few hours. However, if the pancreatic ducts are open and pancreatic hypertension is relieved, amylase can return to normal in just a few hours, and if amylase is checked at this time, it is easy to misjudge, and other pathological stages are easy to misdiagnose. Regrettably, nowadays, medical appointments and examinations are carried out as they happen, with the time of the patient and the outpatient doctor arranging the examination at will, without considering the evolution of the disease. 2, should not be demanding “the first diagnosis confirmed”: the evolution of the disease has its own laws, a variety of test results are also gradually out, expecting a single outpatient or a single examination to get clear a difficult disease is unrealistic, only through a series of tests (if necessary, also need to hospitalization), after a period of time, through multidisciplinary consultation, grasp the evolution of the disease law This process I summarize as “a definite diagnosis” to “gradually definite diagnosis”. 3, the professional back to the professional: “academic specialization”, especially in today’s highly developed medical disciplines are becoming more and more subtle, experts are becoming more and more specialized, do not expect to encounter all-round talent, encounter specific medical problems, drug problems ask the study of drugs, ultrasound problems ask the B ultrasound, testing problems ask the testing, imaging problems ask the imaging. Don’t put your hopes on so many professional problems to be solved by the clinical experts who are specialized in treating diseases in the limited clinic time. 4, tell the truth to the doctor: Chinese people have a habit of looking for different experts to consult the same problem, hoping to find the answer that meets their needs from different experts’ answers, and often hide important medical history and tests to avoid preconceived ideas, which is not only detrimental to the timely diagnosis and treatment of diseases, but also a great waste of limited quality medical resources. I have received patients from the United States, Japan, Canada and other places, they have not enjoyed the “privilege” of seeking free consultation with multiple specialists from different hospitals for the same disease within a short period of time. 5, do not blame the doctor: If you have to be blamed for a miscarriage of justice, doctors still dare to take responsibility? Do not dare to take responsibility for the medical progress? Can patients still get better medical treatment? Of course, doctors should do their best to avoid and reduce the rate of misdiagnosis.