Who should listen to the doctor's disagreement

 　　When you get sick, people will suddenly have no masters, asking about how to treat them. There are often complaints from patients that when they go to many hospitals, the doctors say they are not the same. Even in a hospital, what the experts say is different. Faced with different diagnosis and treatment options, who should you listen to?

　　In fact, medicine has developed rapidly, and doctors are not very clear about many diseases, and there are still great limitations. In addition, even if doctors are well aware of some diseases, there are still individual differences. Each patient's treatment is different. It can be said that no two patients in the world are exactly the same. Therefore, there is no "gold standard" for the diagnosis of many diseases, only expert consensus.

　　After the patient got sick, he was eager to know what kind of disease he was, thinking that the disease was either black or white. The doctor must give me a clear statement. However, many times your disease is gray.

　　Clinical medicine is an empirical medicine. There are many diseases that will not follow the book. Atypical symptoms are also the reason why some doctors misdiagnose.

　　When the patient encounters such a situation, he must be patient and wait for the examination. In fact, most of the time the opinions of doctors are not very different. If there is a big difference, listen to their reasons. Every doctor has a different perspective, and the opinions given may vary. Of course, the diagnosis and treatment of a good hospital will not vary greatly, and there are standards for the same diseases, and there is evidence to follow. The multidisciplinary consultation system can focus on consultations to give directions and opinions for examinations, and avoid patients with difficult diagnosis from running back and forth between various departments.

　　Listen more to the doctor's opinions, not only use medical knowledge to analyze whether what each doctor said is reasonable, but also use logical thinking to find out the results you mainly want. In the treatment of diseases, there are few methods that have the best of both worlds. There are gains and losses, and there is no regret medicine. It should be right to follow one direction to the end.

　　In addition, "finding evidence" is also the essence of modern medicine. Most of today's medicines and treatment plans need to go through rigorous clinical trials and have sufficient scientific evidence before they can be applied in practice.

　　For example, the new crown pneumonia vaccine that is being vaccinated is not started by a very authoritative or experienced person who said that it is necessary to vaccinate. It is a large-scale vaccination after scientists have conducted arduous research and experiments and have evidence to ensure that the vaccine is safe and effective.

　　What is evidence? The doctor's personal clinical experience, published academic literature, etc. are all evidence, but the level of effectiveness is different. The clinical trial method with the highest level of evidence is called a "multicenter randomized controlled study".

　　Simply put, the patients were randomly divided into two groups. One group took the new medicine and the other group took the old medicine, but the doctors and patients did not know who used what medicine. This is the so-called "double-blind" test. And this trial must be done not only in one family, but also in many hospitals around the world, that is, multiple centers. In this case, if everyone comes to the same conclusion, it means that the medicine is effective. This is the highest level of research evidence.

　　Treating a disease is a lot like solving a case. Doctors do various examinations on patients, just like the police are looking for clues to the crime. When the clues are not enough, there may be several suspects, just like diseases, different doctors may have different judgments. The more clues and the better the evidence, the more likely it is to find the real culprit.

　　In this sense, in the face of different statements from doctors or different treatment options, finding more evidence may be more important than finding "authority."

　　Of course, this is not easy, because the evidence will not jump out on its own, and the complicated information also needs to be screened out as valid evidence.

　　Some people may think that patients do not understand medical knowledge and how to make decisions. But the objective reality is that the final decision is for the patient to make, which cannot be replaced by others. After all, the results of all treatments, good or bad, are borne by the patient's body.

　　In short, don't go to the hospital in a hurry. When choosing a reliable hospital and doctor, you can consider the following points:

　　Choose a specialist hospital. As the saying goes, "what are you doing and what to drink". Doctors in non-specialist hospitals are smarter than general hospitals, but they just yell at this, and they are always good at it.

　　Go to the general hospital to find a specialist doctor. Now general hospitals are also divided into specialties, and doctors above the deputy chief physician also have specialties. There are relatively few large and comprehensive general hospitals. Many general hospitals also focus on one or two specialties. For example, Beijing's Tiantan Hospital is well-known for brain surgery, and Jishuitan Hospital is leading the Department of Orthopedics and Burns.

　　You can first ask the doctor's friends for their opinions. If you can know doctors, their recommendations are more reliable because they understand the situation in the industry.

　　Patient recommendations should be carefully considered. This is relatively subjectively affected, and is directly related to the patient's treatment effect and medical experience, and is not very objective.

　　Don't take the results online too seriously. At this stage, there are not too many reliable ones, so don't be misled.

　　Private private hospitals are currently a mixed bag, and some do not follow the standard treatment and practice medicine, eager for quick success and instant benefits. If you want to choose these hospitals, try to find a larger hospital for treatment, and it is not ruled out that individual private hospitals are very standardized.

　　Some patients believe in Chinese medicine and traditional Chinese medicine, and they even look for public hospitals when they go to Chinese medicine hospitals. For example, Guang'anmen Hospital of Traditional Chinese Medicine, Xiyuan Hospital of Traditional Chinese Medicine, etc.