I have written about the need to get as accurate a diagnosis as possible for any medical problem you might have. Asthma is one of many pulmonary diagnoses which need to be correct for many obvious reasons. Giving a patient a diagnosis which will require lifelong management and treatment is a serious matter. Many patients come to our office carrying this diagnosis and we are asked to see them because their treatments are not working. I have said many times that when a treatment does not work it is because it is the wrong treatment or you have the wrong diagnosis.

Our colleagues to the north have found out that many of their patients who carry the diagnosis of asthma and have been taking medication, sometimes for many years, have been misdiagnosed. The source of the misdiagnosis is the lack of specific testing to detect the basic physiologic flaws in patients with asthma. Physicians in Canada looked at 612 cases of “asthma” and found that 33% of these patients previously diagnosed with asthma did not have the disease and were able to stop their medications.

The periodic and reversible constriction of the airways that is the hallmark of the asthmatic patient can be demonstrated in several ways. The generally accepted test to confirm the diagnosis in most patients is called a Broncho Provocation study. It is a relatively simple test which is done in our office. This test helps to establish, once and for all, the diagnosis of asthma.