The trajectory of healthcare points towards a paradigm shift: integrated care. With each new revelation in scientific understanding of the human body, the less likely it becomes that any one person will have the necessary knowledge needed for comprehensive patient care. When it comes to medical symptom research, some may suggest that artificial intelligence holds the potential to assist in this endeavor. However, one cannot ask questions they do not know to ask. Solutions to this complex problem are beginning to arise. What follows is merely one idea to potentially help address this growing issue.

Introducing the Symptom Research and Diagnostic Consultant (SRDC), a potentially innovative and transformative addition to the medical field. With specialized expertise in comprehensive symptom research, analysis, and consultation abilities, the SRDC collaborates closely with physicians to tackle complex cases and provide valuable diagnostic information. By conducting thorough research, compiling comprehensive lists of potential causes, and offering expert insights, the SRDC frees up physicians’ time, equips them with diverse diagnostic options, and elevates healthcare standards, leading to improved patient outcomes. Embracing this multifaceted professional promises to revolutionize the diagnostic process and enhance the overall healthcare experience.

Background and Reasoning:

People with long-term health problems often experience significant delays in getting diagnosed because doctors often don’t have enough time to fully explore different treatment options (Isono et al., 2022). These delays can last years. Studies from the U.S. and the U.K. have shown that many doctors feel they lack sufficient time to properly diagnose patients, which contributes to missed opportunities for disease resolution. Unfortunately, this shortage of time for doctors to research treatments and discuss options during appointments has serious consequences for both healthcare and patients’ well-being (Awdish & Berry, 2020).

A recent study found that if primary care doctors followed national guidelines for preventive, chronic, and acute care, they would need 26.7 hours a day to see the average number of patients (McPhee, 2022). This mismatch between guidelines and available time has big implications, forcing doctors to focus on reacting to problems rather than preventing them (SteadyMD, 2018). This slow approach to improving patient outcomes is a problem, especially for vulnerable groups, and it’s even worse when dealing with unclear symptoms.

Time is a factor, but so is a lack of knowledge. For example, a proper diet is important for good health, but most doctors are not trained to focus on nutrition. Research by Jennifer Abbasi shows that many medical students don’t receive enough education about nutrition (Abbasi, 2019). This is backed up by a 2015 survey that found 71 percent of medical schools provide less than the recommended 25 hours of nutrition education, and over a third of schools offer less than half of that (Adams et al., 2015). Of course, that may not matter anyway because much of the information regarding diet in mainstream medicine is outdated.

Similarly, exercise is crucial for health, but it’s not a priority in medical education. In a 2015 study of medical schools, researchers found that only 12.2 percent of students had a required course related to physical activity (Devries et al., 2017). Another study from 2015 showed that more than half of American doctors receive no formal education in physical activity (Cardinal et al., 2015).

Together, these represent one of the more pressing issues in modern medicine. According to the CDC, sixty percent of Americans deal with some kind of chronic ailment (CDC, 2019). The leading causes of death in the United States, like heart disease, cancer, and diabetes, stem from chronic diseases (CDC, 2019). However, recent research in PLOS One suggests that these diseases are not usually genetic or contagious. Instead, the study, which echoes the CDC, suggests that over 85 percent of chronic diseases come from lifestyle choices, including diet and exercise (Rappaport, 2016). However, the symptoms of these diseases often start off vague, making them easy to overlook by both patients and doctors, especially when time is limited.

Holistically, we can see that the leading causes of death and chronic disease are rooted in the very things that most physicians are not trained in. Compounding the issue is that chronic illnesses need different care compared to sudden illnesses. Meanwhile, delayed diagnosis, inadequate treatment, unproven approaches, and managing symptoms instead of aiming for a cure can increase costs and put patients at risk of various problems, from dependency to even death. We need to take action to address these issues. Physicians need a Symptom Research and Diagnostic Consultant!

The Potential Answer:

Health science serves as an interdisciplinary cornerstone within healthcare, aiming to enhance health results through the advancement of insights and strategies concerning overall well-being, as well as the prevention and treatment of illnesses (Nature, 2020; ScienceDaily, 2020). The West Indian Medical Journal once showcased Health Science as a promising prospect in healthcare, given its focus on the origins of diseases, physical activity, dietary aspects, health governance, educational endeavors, and the economic dimensions of health (Ashraf, 2015). However, Health Science is still trying to find its place, and only limited investigations are underway to explore its potential applications. This situation presents a unique opportunity for both physicians and Health Science professionals.

Allowing Health Science professionals to play a more prominent role in overall health care would increase options for patients and doctors, increase access and knowledge, reduce costs, reduce burdens on physicians, reduce waste, and likely result in better outcomes as patients receive more options for their conditions. Physicians would benefit greatly from having someone with this background coupled with strong research abilities to aid in disease discovery and resolution options.

In this role, this professional would merely help to generate options and utilize their Health Science background and research skills to help identify potential links related to the often ambiguous symptoms presented. Physicians need a Symptom Research and Diagnostic Consultant as a member of their team. Here’s what this might look like:

Role Responsibilities:

These individuals would have various responsibilities related to medical research, symptom analysis, and providing expert advice to the healthcare team. Here are some common tasks they might perform:

Second Set of Unbiased Eyes: Assisting physicians in evaluating complex and ambiguous cases, offering potential diagnoses and medical conditions for consideration.

Question Generation: Behavior-related disease requires a different set of questions. These individuals can help formulate the necessary questions to help discover the root of ambiguous symptoms.

Literature Review: Conduct in-depth literature reviews to gather the latest medical research on specific symptoms or conditions.

Data Collection: Collect relevant medical data from patient records, research databases, and other reliable sources to build a comprehensive understanding of symptoms and potential diagnoses.

Patient Assessment: Review patient medical records and symptoms to identify patterns, potential triggers, and associated conditions.

Symptom Analysis: Analyzing patient symptoms and comparing them with existing research to identify potential causes or conditions.

Report Preparation: Compiling research findings and creating brief lists for a physician to consider or comprehensive reports summarizing relevant information for physicians and other healthcare professionals.

Collaboration: Collaborating with physicians and other healthcare team members to discuss research findings and provide insights for patient care decisions.

Continuous Learning: Staying updated with the latest advancements in medical research, symptomatology, and diagnostic approaches to enhance the quality of research and analysis.

Case Discussions: Participating in case conferences with healthcare teams to provide symptom-based insights and research-backed suggestions for patient management.

Medical Database Use: Utilizing medical databases and online resources to access relevant information and studies related to patient symptoms.

Information Organization: Organizing and presenting symptom-related data and research findings in a clear and accessible format for medical professionals.

Patient Follow-up & Referral Suggestions: Tracking patient progress and outcomes to assess the accuracy of symptom analysis and research-informed recommendations and provide referral options for the attending physician.

Education and Training: Conducting training sessions for healthcare professionals to enhance their understanding of symptom analysis and research interpretation.

Role Requirements:

Qualifications for individuals in these roles can vary based on the healthcare team or clinic’s specific needs, requirements, and expectations. However, here are some general qualifications that could be relevant for this position:

Education: These individuals may have a dedicated degree or specialty (at any level) in a relevant field, such as biology, biochemistry, biomedical sciences, or a related discipline. However, it also needs to be understood that conditioned education provides conditioned answers and approaches. Hence, it is more essential that these individuals have a strong understanding of epidemiology principles, applied nutrition, physical activity testing and prescription, applied sports medicine, and the ability to prove their strong research abilities. This is Health Science in a nutshell.

Research Experience: Previous experience in medical research, symptom analysis, or related areas is valuable. However, the ability to research from an unbiased lens is critical. What is necessary here is that this worker be able to prove that they can examine the information and build a strong narrative.

Qualitative Research Experience: This type of experience is vital for this role as it enables a deeper understanding of patient experiences, helps identify unmet needs, informs hypothesis generation, improves patient communication, contextualizes quantitative data, enhances empathy, supports evidence-based decision-making, and identifies treatment preferences.

Medical Knowledge: Familiarity with medical terminology might be helpful. However, it is more important that this candidate be familiar with anatomy and physiology and understand and interpret research articles and medical data. Specifically, this person needs strong knowledge of chronic disease processes (especially regarding nutrition and activity); they must understand and analyze patient symptoms accurately and provide multiple options for potential resolution or management.

Critical Thinking: The ability to think critically and approach symptoms from different angles is vital in evaluating potential diagnoses for chronic disease and proposing relevant courses of action.

Problem-Solving Abilities: Be skilled problem solvers, as they’ll encounter complex and ambiguous cases that require careful examination. Thinking outside the ‘healthcare box’ is vital in chronic disease epidemiology.

Analytical Skills: Strong analytical abilities are necessary to process complex medical information, identify patterns, and draw meaningful conclusions from research findings.

Collaboration: Working closely with physicians and other healthcare professionals requires good collaboration skills to ensure effective communication and teamwork.

Data Management: Proficiency in data collection, organization, and analysis is crucial for compiling relevant information and creating comprehensive reports.

Communication Skills: Effective written and verbal communication skills are essential to accurately convey research findings to physicians and other healthcare professionals.

Advisory and Consultation Skills: Strong consulting skills are essential as they’ll provide expert advice, guidance, or options to healthcare teams and physicians.

The Ability to Let Go: This individual needs to provide potentials while recognizing that they are not the physician tasked with making the ultimate decision.

Personable and Flexible: Much of this work can be done remotely. This ability will save the clinic time and money. However, the individual in this role will occasionally have to interview the patient to ask more pointed questions or meet with the team to discuss various cases. Hence, this individual must be personable and professional while working independently and in a team environment.

Conclusion:

The concept of a Symptom Research and Diagnostic Consultant is undeniably innovative and tackles specific and necessary healthcare challenges. Indeed, this is merely a suggestion. However, it’s essential to recognize that this unique combination of responsibilities constitutes a relatively new and distinct role that addresses several specific issues. Despite its novelty, we must not underestimate its significance. In essence, the role of a Symptom Research and Diagnostic Consultant holds immense potential in enhancing patient outcomes and healthcare efficiency. By offering invaluable support to physicians and healthcare teams, there is a very good chance that it can substantially improve patient care.

Resources:

Abbasi, J. (2019). Medical Students Around the World Poorly Trained in Nutrition. JAMA. https://doi.org/10.1001/jama.2019.17297

Adams, K. M., Butsch, W. S., & Kohlmeier, M. (2015). The State of Nutrition Education at U.S. Medical Schools. Journal of Biomedical Education, 2015, 1-7. doi:10.1155/2015/357627

Ashraf, MA (2015). Special Issue on Health Sciences. The West Indian Medical Journal, 64(5), 461.

Awdish, R. L. A., & Berry, L. L. (2020, October 26). Making time to really listen to your patients. Harvard Business Review. https://hbr.org/2017/10/making-time-to-really-listen-to-your-patients

Cardinal, B. J., Park, E. A., MooSong Kim, & Cardinal, M. K. (2015). If Exercise is Medicine, Where is Exercise in Medicine? Review of U.S. Medical Education Curricula for Physical Activity-Related Content. Journal of Physical Activity & Health, 12(9), 1336–1343.

CDC. (2019, October 23). About Chronic Diseases. Retrieved July 17, 2020, from https://www.cdc.gov/chronicdisease/about/index.htm

Devries, S., Agatston, A., Aggarwal, M., Aspry, K. E., Esselstyn, C. B., Kris-Etherton, P., Miller, M., O’Keefe, J. H., Ros, E., Rzeszut, A. K., White, B. A., Williams, K. A., & Freeman, A. M. (2017). A Deficiency of Nutrition Education and Practice in Cardiology. The American Journal of Medicine, 130(11), 1298–1305. https://doi.org/10.1016/j.amjmed.2017.04.043

Isono M, Kokado M, Kato K. Why does it take so long for rare disease patients to get an accurate diagnosis?-A qualitative investigation of patient experiences of hereditary angioedema. PLoS One. 2022 Mar 18;17(3):e0265847. doi: 10.1371/journal.pone.0265847. PMID: 35303740; PMCID: PMC8932585.

McPhee, D. (2022, August 11). Primary Care Doctors would need more than 24 hours in a day to provide recommended care. University of Chicago News. https://news.uchicago.edu/story/primary-care-doctors-would-need-more-24-hours-day-provide-recommended-care

Nature. (2020). Health sciences. Retrieved July 18, 2020, from https://www.nature.com/subjects/health-sciences

Rappaport, S. M. (2016). Genetic Factors Are Not the Major Causes of Chronic Diseases. Plos One, 11(4). doi:10.1371/journal.pone.0154387

ScienceDaily. (2020). Health science. Retrieved July 18, 2020, from https://www.sciencedaily.com/terms/health_science.htm

SteadyMD. (2018, August 22). Most primary care doctors don’t have enough time for you. SteadyMD. https://www.steadymd.com/blog/primary-care-doctors-no-time-patients/

© 2023 Dr. David M Robertson. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means or stored in a database or retrieval system without the author’s prior written permission.

Be sure to check out my article ChatGPT Is No Health Expert