Shortness of breath. Expert medical second opinion. Multidisciplinary team assessment. 6
Patients with shortness of breath spend 2 years to get correct diagnosis. They often spend up to $150000 on diagnostic tests and consultations. Doctors often repeat the same tests even though these tests have not provided an answer. Leading lung disease expert explains. Shortness of breath is such a common symptom. Requirement to diagnose shortness of breath properly is a very important point. Because it is important to investigate breathlessness thoroughly and with an open mind. Dr. Aaron Waxman, MD. A physician cannot silo a patient into a common diagnosis. The diagnosis could be wrong, it might have nothing to do with the causes of patient’s shortness of breath. This is the biggest problem that we have in a lot of aspects of medicine. It is how we have siloed our specialties. Dr. Aaron Waxman, MD. Here is a unique feature of our pulmonary vascular program and our dyspnea program. We are a group of clinicians that includes pulmonologist, cardiologists, rheumatologists, and radiologists. But we cross boundaries of our specialties. We even have surgeons who are part of our clinical group. It allows us to think much more broadly and open-mindedly. It also gives us lots of questions that we can then address from a research standpoint. This is the theme that I clearly hear from many medical experts. A multidisciplinary approach to diagnosis. This is crucial for finding the best treatment for any disease. Dr. Aaron Waxman, MD. Yes. It is the only way forward in medicine. A patient might have experienced certain symptoms. Some physicians then tell this patient. “Oh, you have this or you have that diagnosis.” It may be worthwhile to investigate the symptoms in more detail. It’s crucial to find the right expert. An expert who will dig into the real causes of patient’s symptoms. It is not easy to make a correct diagnosis. But nevertheless it is worthwhile for the patient. We went back and looked at our patient population. We probably see on the order of two or three hundred new patients every year with unexplained shortness of breath. Dr. Aaron Waxman, MD. We are following well over a 1,000 patients at this point. We learned that the average time to diagnosis for the patients with shortness of breath is about two years. This is the patients we have seen. Time period to diagnosis means from the time patients started to complain of breathlessness to the time they got to our evaluation. These patients have been complaining of shortness of breath for at least two years. Over those two years many times people have spent upwards of $100,000 to $150,000 on diagnostic testing. Dr. Aaron Waxman, MD. Physicians were repeating diagnostic tests over and over again. Because physicians want to do something for the patient. If a physician can not treat something, they are often going to order a diagnostic test. Even though that diagnostic test has been done before. Even if it hasn’t shown an answer. It is what the physicians are comfortable with. They are comfortable with repeating the same diagnostic tests again and again. A lot of money is spent. A lot of time is wasted in getting these patients a correct diagnosis. Patients could have used the modern technology to get the correct diagnosis. Dr. Aaron Waxman, MD. Patients could receive a remote expert medical opinion. They could send the medical information to the correct expert in shortness of breath diagnosis. patients with shortness of breath should try to find correct medical expert to find a cause of their symptoms. It could have saved both time and money. Getting the right diagnosis means receiving appropriate treatment for shortness of breath, at the right time. Correct! That is the key. For us, by the time a patient knocks at our door, we can usually give that patient a correct diagnosis. Dr. Aaron Waxman, MD. Only because the scheduling issues could be a problem. We are booked out for patient appointments months in advance now. Within 6 weeks we can usually give a correct diagnosis to any patient with shortness of breath. For every diagnosis we find, we do have a treatment protocol. Effective treatments are evolving as time goes on. Dr. Aaron Waxman, MD. We have learned a lot about these diagnoses. We are thinking about treatment for shortness of breath on a physiologic basis. It allows us to be flexible and to tailor therapy to that patient. It pays to get to the correct experts! Everything is about finding the right person.
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