Chief Complaints

As physicians, we all have our favorite things to see. Some prefer managing diabetes. Some prefer hypertension. Some prefer acid-base disorders. You get the picture. I think we all have some disease process we prefer over another. The opposite holds true as well.

There are certain Chief Complaints that make me cringe before I go into an exam room. For me, these are the complaints that usually take much more time to work up, more time to listen to the history because there is usually a long story that goes with it, few objective findings on examination and the labs are usually normal. For me this also includes those complaints that, after the workup is complete, it takes more time to convince that patient that there is nothing wrong than it would have taken to treat something had it been there. Some of these have the potential to be very real illnesses and I just don't particularly enjoy working them up. But we do what we have to do to take care of the patient no matter how we feel about the complaint.

The Chief Complaints I hate to see on the chart are (in David Letterman style):

10. Rash.
9. Abdominal Pain.
8. Headache.
7. Dizziness.
6. "I want to get a prescription to lose weight."
5. Insomnia.
4. Constipation.
3. "I need my pain meds."
2. Fatigue.
1. "Dr. Blogger, your mother called and her doctor is out of town and she needs to talk to you about her meds."

For the record, this is not meant to be derogatory towards any patient. Just things I don't personally like to work up. Yet, like other physicians whose list may be similar or different, we have a desire to take care of the patient and his or her needs so we jump right in and take care of it (except in the case of #1 and she has to just wait on her doctor).

I would be interested to hear others' lists.