Docs trapped in Catch-22 situation

When famed physician William Osler wrote almost a century ago that "medicine is a science of uncertainty and an art of probability", he could not have foreseen that the practice of medicine would evolve so dramatically in the new millennia.

We can now peep into every nook and cranny of the human body, examine up close the biochemical workings of cells, and monitor intimately all physiological functions - but all at great expense, which needs to be balanced against cost effectiveness.

It is not true that general practitioners are dismissive of patients' complaints (Don't make light of patients' cancer claims, by Ms Kimberley Lim, June 24), especially in this age of easy information.

The familiar adage that common things happen commonly applies well to the medical profession.

A doctor, seeing a plethora of diseases presenting in a multitude of ways, tends to cluster and categorise symptoms into what is possible but unlikely, and that which is probable and likely.

Correlated with the signs of various differential diagnoses, a plan is then worked out to investigate, treat or refer the patient.

Doctors are often exhorted not to be "kiasu" and to eschew the practice of defensive medicine.

Yet when they follow this advice, they are trapped in a Catch-22 situation when complaints like Miss Lim's crop up. It is difficult not to empathise and side with her.

Patients should give their doctor a chance to correct any oversight. Second or third visits to the same doctor will prompt him to be more circumspect of the increasing possibility of the rare event happening in an improbable situation.

But if patients feel the doctor has been remiss and the correct diagnosis still has not been reached, seeking a second opinion would be astute.

Yik Keng Yeong (Dr)

A version of this article appeared in the print edition of The Straits Times on June 28, 2017, with the headline 'Docs trapped in Catch-22 situation'. Print Edition | Subscribe