posted by editor on Feb 4
You (patient) present to your primary care physician in the following manner.
Chief complaint – low back pain.
Subjective data – You report no prior lumbar pain with the recent onset of pain occurring after engaging in excessive lifting while helping a a friend move. You report to not be in treatment for any other medical conditions. You report no other symptoms or health concerns. You claim to work out at the gym regularly.
Objective findings – You are a 35 y/o male, in no apparent distress. You are 6 ft. tall and weigh 220 pounds, with a very muscular build. Your physical examination is unremarkable except for reporting slight tenderness in the lumbar area. No radiological studies are deemed necessary today.
Assessment – lumbar sprain/strain
Plan – It is my perspective that “to a hammer, the whole world is nails.” By analogy, if your doctor were a carpenter he would try nailing you back together. As such, consider your clinician’s training and experience when pursuing an evaluation and intervention. If s/he is a Internist expect the focus of treatment to be on prescription medicines. If a surgeon, s/he will be primarily concerned about determining the merits of operative intervention. If you visit a chiropractor you will hear about your skeletal misalignment and need for adjustment. Others will refer to body energy, conditioning status, need for modalities application, psycho-spiritual status modification, and/or invocation of dietary/supplement consumption changes and use of herbs. There will be some with multiple skills and experiences, but not every clinician will match your expectations. The initial treatment plan will probably reflect the intersection between their training, experience, beliefs, organization affiliation, and recognized models/insurance standards of care versus your beliefs and expectations. Sometimes the intersection is nominal and you feel that you are being inadequately treated. However, a very fine carpenter doesn’t become a experienced electrician simply because you ask. Maybe s/he can nail you back together, or maybe you need to seek an alternative clinician.
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