Posted by: notdeaddinosaur | July 10, 2016

Openings: Part 1

What are the worst Chief Complaints you’ve ever heard?

For the non-medical reader, the Chief Complaint can be thought of as the patient’s opening statement. It’s what shows up on the schedule as the only thing I know about why the patient is there. I’ve compiled a brief and definitely non-exclusive list of the worst chief complaints I’ve ever seen; the ones that make me sigh in advance, knowing that taking the history is going to be like pulling teeth and that the patient is probably not going to be satisfied.

Here goes:

  • “Nerves”
  • “Fatigue”
  • “Depression”
  • “Anxiety”
  • “Low back pain”
  • “Dizziness”
  • “Numbness”
  • “Palpitations”
  • “Chest pain for three years”
  • “My breathing is funny”
  • “Sick”
  • “Chronic” anything
  • “Couple of things”
  • “Just a few questions for the doctor”

And my favorite:

  • “I’m just not right”

Feel free to add more in the comments.

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Responses

  1. My favorite is I’ve had a horrible unbearable toothache for months that I cannot take anymore. So, I say come in this second and they say they cannot because they have to work or busy or going on vaca.

  2. I understand your frustration. My 84-year-old mom is one of those patients. I go to her doctor’s appointments with her, and I ask her questions in advance to try to narrow down what she means by “I just don’t feel well.” We go through 20 questions — are you feeling nauseated? are you dizzy? do you have a fever? do you feel chilled/clammy? where do you hurt? what kind of pain is it? have you had a bowel movement today? (though she doesn’t always remember if she has or not.) Part of it is mild cognitive decline. I once noticed on the phone that she seemed to be working a little harder to take breaths, so I asked her if she had shortness of breath, and she thought about it and said, “I hadn’t noticed, but I guess I do.” I feel sorry for older people who don’t have an advocate to look out for them and help them communicate with doctors.

  3. Then there is what I have experienced. The doc asks why I am there and I say, ” I am not having any problems but your staff ordered me in for a 6 month well check. They say this is required for me to remain a patient in your practice.”

  4. If I told my doctor the truth, my chief complaint would always start with “I think I have cancer.” Because I have had cancer and that is always the first thing that jumps into my mind whenever I get sick. So I don’t start there. But sometimes the only thing I can tell him is that I am very fatigued and …add whatever symptom afterward. I’m sure it sounds as vague and nonspecific as anything you have above.

  5. ‘Not better’-last seen 9 months ago

  6. I can hear my heart beat.

  7. Not just “dizzy,” but “dizzy all over.”

  8. ‘I have a rash’-when they point to it there is nothing there but completely normal skin

    Saw a patient in the hospital recently. Family was mad because the front staff wouldn’t make an urgent office appt for their mother with chest pain.
    On further research, pt was offered an appt with 2 different doctors and the nurse practitioner that same day and one was available to see here literally right then. But she wanted an urgent/emergent appointment with her doctor.
    Somehow that led to the chief complaint of ‘my doctor wouldn’t see me’

  9. Have heard every one of these. And then there’s “talk about some things,” followed by “my brain is itching.” And all of the above cause the same thought in my mind: “AIEEEE!”

  10. You forgot vague abdominal complaints and “I have tried everything but I can’t lose weight.”

    I, too, detest “depression,” “nerves,” and “anxiety.” I’m an internist, not a psychiatrist. You wouldn’t go to a shrink for diabetes; don’t go to an internist for depression and anxiety. I check for hypercalcemia and thyroid disease and then refer them to mental health providers.


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