Our office often sees patients who have been treated for some time for a problem they have been told they have, but the therapies that have been offered have not been helpful. It is not unusual for patients to be having symptoms for months without benefit from the ongoing treatment they are receiving.

Here is a good rule of thumb to remember. When you are receiving treatment for a problem and you get no relief, especially if you have been treated for some length of time, either the treatment is wrong or the diagnosis is wrong. Obviously, this may not apply to everyone but it is still a good rule of thumb. The most common situation we see involves asthma or COPD, where the patient has been told to have one of these diseases, but no confirmation has been made through laboratory testing.

In the case of COPD, the diagnosis cannot be made without a pulmonary function study that shows the chronic airflow reduction. In the case of asthma the baseline studies may be normal, but a test that challenges the patient and unmasks the bronchial constriction characteristic of the disease was never performed. In the old days patients would take the doctor’s word for the diagnosis, but today we strive to prove to the patient and ourselves that certain problems are present. Judgments still need to be made, but so do accurate diagnoses. Not all problems have a specific lab test, but when possible discuss the proof of your diagnosis.