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Navigating through the swampy lowlands - Dealing with the patient when the diagnosis is unclear

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By L. Stone • • December 20, 2006

Journal: Australian Family Physician. 2006 Dec;35(12):991-4. [The full text of this article is available for free in PDF at ] Author and affiliation: Stone L., MBBS, BA, MPH, DipRACOG, FRACGP, FACRRM. Medical Educator, SIGPET, New South Wales. PMID: 17149475

Case study: Jenny, 56 years of age, is well known to your practice. Your registrar asks for advice regarding her management. Together you summarize her history: noninsulin dependant diabetes, Irritable Bowel Syndrome, chronic headache, and a background of social and emotional issues. She is obese, a light smoker, and has worked intermittently since her youth. You know her marriage is rocky and her children have had various health issues including Chronic Fatigue Syndrome. You admit to some ambivalent, if not overtly hostile feelings toward Jenny, and you are uncomfortable acknowledging this; it seems so unprofessional. Her current issue is joint pain, for which the diagnosis is unclear despite referral and investigations. How can you help your registrar manage this patient?

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