4 ms·

I think that the point is that it isn't enough evidence to make a diagnosis. The article expands on why it is inappropriate for a psychiatrist to make a recomme

I think that the point is that it isn't enough evidence to make a diagnosis. The article expands on why it is inappropriate for a psychiatrist to make a recommendation related to back pain. He's not just "the doctor", he's a specialist with a license to practice a limited set of medicine. What should a psychiatrist write on a doctor's note if his patient claims to suffer from cancer, no other evidence given than the claim itself? Now, depression, that's something a psychiatrist can legitimately diagnose.

dmurray 8y ago
> What should a psychiatrist write on a doctor's note if his patient claims to suffer from cancer, no other evidence given than the claim itself? Probably nothing? I don't think it's appropriate for the psychiatrist to inform the employer of possible Munchausen syndrome.
- boomlinde 8y ago
  So why is this different from the patient claiming to suffer from chronic back pain?
  - dmurray 8y ago
    Because the main symptom of back pain is the patient reporting "My back hurts". If the patient instead reported "I have this lump in my testicles that wasn't there last week", I'd certainly think it's likely he might have cancer, and some good medical advice would be "go and ask a GP about that".
    - boomlinde 8y ago
      Back pain is a symptom in itself. Maybe a disk has been shifted, or it's caused by a kidney infection. Maybe it's just muscle pain or sciatica related. Hell, for all we know, the back pain is caused by the chair in question. Without proper examination you can't rule these things out and make a professional recommendation as to what to do about it other than "go see an expert or general practitioner". By phrasing the recommendation the way he did he made sure that it is understood that a) he is treating the patient for an unrelated issue, b) he isn't in a position to diagnose back related problems and c) he never examined the patient's back problems.

dmurray 8y ago

> What should a psychiatrist write on a doctor's note if his patient claims to suffer from cancer, no other evidence given than the claim itself? Probably nothing? I don't think it's appropriate for the psychiatrist to inform the employer of possible Munchausen syndrome.

boomlinde 8y ago
So why is this different from the patient claiming to suffer from chronic back pain?
- dmurray 8y ago
  Because the main symptom of back pain is the patient reporting "My back hurts". If the patient instead reported "I have this lump in my testicles that wasn't there last week", I'd certainly think it's likely he might have cancer, and some good medical advice would be "go and ask a GP about that".
  - boomlinde 8y ago
    Back pain is a symptom in itself. Maybe a disk has been shifted, or it's caused by a kidney infection. Maybe it's just muscle pain or sciatica related. Hell, for all we know, the back pain is caused by the chair in question. Without proper examination you can't rule these things out and make a professional recommendation as to what to do about it other than "go see an expert or general practitioner". By phrasing the recommendation the way he did he made sure that it is understood that a) he is treating the patient for an unrelated issue, b) he isn't in a position to diagnose back related problems and c) he never examined the patient's back problems.