DISCUSSING DIAGNOSIS AND TESTS

A patient’s main diagnosis and its treatment may be simple or complex. It is natural for the patient to worry and ask questions. You need to:

• provide main and other possible causes of their problem
• describe tests they will need
• explain possible treatments
• answer questions about treatment and outcome (cure or control)

If the diagnosis is clear or obvious, you are confident. If the diagnosis is not so obvious, then your language shows less confidence until you do more tests or investigate further.

A clear diagnosis:

• I’m pretty sure / very sure / quite sure you have…
• I’m certain you have …
• You have…
• You have what is called…

A possible diagnosis but you need to investigate further:

• I think you have…/ I think you have what is called…
• You might OR may have…
• You probably have…
• It’s likely you have…
• It’s most likely …
• It appears to be…
• It seems OR sounds OR looks like …
• It’s possible you have …

When more than one cause is possible:

• You might OR may have… or ….
• It could be either … or …
• The most common cause is … but it could OR might also be…
• There is more than one possible cause.

When you need to do more tests:

• I would like to do OR arrange OR order OR schedule some tests
• We need to do tests to confirm or rule out … (a diagnosis)

When you have the test results:

• The tests OR results have ruled out (+ illness they do NOT have)
• We’ve ruled out…
• We’ve managed to rule out …
• The tests have excluded X (X = illness they do NOT have)
• The tests OR results have confirmed  Y (Y= illness they DO have)
• The tests show OR confirm that …
• It’s definitely… (when you are 100% sure of the diagnosis!)

An old diagnosis that is getting worse:

• Unfortunately, it seems that OR it looks like…
• The tests show that, unfortunately, you / your / the …
• The findings suggest that…

An old diagnosis that is improving:

• It looks like…
• It seems that…
• The tests show that…
• Luckily OR Fortunately, …

Diagnosis based on initial history and physical examination:

• working diagnosis
• probable diagnosis
• primary diagnosis

Other possible diagnoses based on history and physical examination

• secondary diagnosis
• differential diagnosis

Diagnosis confirmed by tests:

• confirmed diagnosis
• definitive diagnosis

See also “APPENDIX P4.1 – Diagnoses – Layman vs. Medical Terms” in resources

READING. EXERCISE A

Instructions: For each statement below, decide how confident the speaker is.