Expectations

I often reach the end of an ER visit without a definitive diagnosis, which is not uncommon for complaints like dizziness, chest pain, or abdominal pain. I explain to the patient all the emergency and serious conditions we’ve ruled out and clarify that I don’t have an exact answer. Patients are often incredulous that I don’t have all the answers.

On one hand, I could feel proud that they think I know so much. They are extremely confident in my abilities and assume I represent the best of medicine. While this seems like a compliment, it doesn’t make me feel better because I know it’s not true. If the ER had definitive answers for every condition patients present with, there would be no need for other specialties. No one would ever need to see a specialist in a clinic if the ER had all the answers.

Clearly, that’s an absurd idea. Our specialty is emergencies and serious conditions. Our breadth of knowledge is wide but not as deep as that of other specialists. When you come to the ER, you should expect that you may not get a definitive answer for your problem. You are more likely to leave knowing what conditions you don’t have rather than a specific diagnosis.

Expectation - reality = happiness.