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The patient looks at me, desperate 鈥� 鈥淏ut what do you think it is Preeya?鈥� Honestly, I have no idea 鈥� which is not what I say out loud to the patient who is getting increasingly anxious about the abdominal pain she has had for 3 days. 鈥淚 know it鈥檚 nothing nasty 鈥� your appetite is normal, you don鈥檛 have a fever, your tummy is soft on examination and you鈥檙e still able to attend work and the gym despite the pain 鈥� so I think we should catch up in 72 hours and see how you鈥檙e going. If anything changes you come sooner.鈥� She stares back at me 鈥� 鈥淥K, but what鈥檚 causing the pain?鈥�

The truth is that we don鈥檛 always have the answer. Despite how the community often perceives us (or how we project ourselves), doctors are not magicians. When I tell my patients 鈥淗onestly, I don鈥檛 know鈥� or 鈥淚 can鈥檛 answer that鈥� I鈥檓 often faced with a shocked expression 鈥� 鈥淏ut you鈥檙e meant to know everything鈥� a patient once said to me.

Single diagnosis? Not always

Medicine is grey, very very grey (certainly more than 50 shades) a lot of the time. Perhaps not all of my colleagues will openly share this 鈥� but we don鈥檛 always have a single diagnosis for a patient鈥檚 tummy ache/headache/fatigue, we don鈥檛 always know what鈥檚 going on in the human body.

As a GP in particular, we often rationalise symptoms; we know common things occur commonly, we know there are certain life-threatening diagnoses like meningitis or an ectopic pregnancy that we cannot miss 鈥� but we can鈥檛 always tell a patient with 100% certainty what is causing their niggling symptom.

Time or what we call 鈥渨atching and waiting鈥� in GP land (as it is known) fixes these non-specific symptoms they have; we may never know exactly what caused their ache or niggle but it settles on its own simply with time.

Recently a friend of mine, also a GP, suggested I explain that when we say 鈥淚鈥檒l just look up the guidelines鈥� or 鈥淚鈥檓 going to check the dose of that鈥� we are not 鈥済oogling鈥�. I鈥檝e heard from multiple patients and family members that a doctor started 鈥済oogling鈥� in front of them; they鈥檙e completely shocked as if the roof on the doctor鈥檚 office had blown off and Dorothy (with Toto) had flown straight over with her ruby red slippers mid-consult.

Guidelines, not Google

On behalf of my profession, let me be honest 鈥� we cannot possibly remember every dose of every drug, every management regime, every set of blood tests that should be ordered when we suspect someone has lupus. We often look at guidelines 鈥� not Google 鈥� from reputable medical bodies that exist to help doctors navigate the abyss of ever-changing medical information.

Sure, there鈥檚 probably the odd doctor who really does 鈥済oogle鈥� but I can tell you most of us don鈥檛. When I say 鈥淚鈥檓 going to see what antibiotic we should use here given you鈥檙e allergic to penicillin鈥� or 鈥淲e need to exclude you don鈥檛 have an underlying cause to your high blood pressure 鈥� let me check which tests we need to do for someone in your age group鈥� I鈥檓 not asking Larry and Sergey (they founded Google 鈥� I had to google that to find that out), I鈥檓 consulting my medical search engines.

And on that note, while we are discussing Google, please know that I have done years (and years!) of study and practical training to sit in my office with my plaque outside my door. So, when a patient says to me 鈥淏ut Google suggested I have a brain tumour鈥� please know that my years of study and the heart beating in my chest make me a sounder medical practitioner than their laptop. I may not have all the answers, I will admit to that, but I promise I can do a better job than Google at diagnosing a headache.

*Dr Preeya Alexander is a practising GP working in Melbourne and a graduate of Adelaide University. She is passionate about all things 鈥榩revention鈥� in medicine. A wife, mother and doctor, Preeya shares her tips on staying healthy with medical-based evidence on her blog The Wholesome Doctor, at .

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