All doctors will do what is known as a “differential diagnosis”. The first part of that process is to take what is known as a “history of present illness”. The doctor will ask when did this pain start and try to find out whether any occurrences that took place may be the cause of your pain. Next, they will physically examine you. Third, they will take a medical history which does not mean they will look at every medical record you have incurred in your entire life, they will simply ask you if you have ever had any similar type injuries or pain, did they go away, did they remain, or were they re-occurring. They are trying to find out if there was anything in your past physical history that may have caused this problem or does your past simply have normal aches and pains that come and go like everyone has. Fourth, and certainly not the last thing that they will look at would be the diagnostic testing – the X-Rays and MRI results.
Once the doctor has all four (4) different portions of the “differential diagnosis” completed they will come up with an opinion of what may have caused the pain that you are suffering. This differential diagnosis can be done by almost any doctor who has experience treating auto injury cases. However, the specific type of doctor who would give this opinion would be a neurologist, orthopedist, doctor with trauma or ER room experience or physiatrist or a nurse practitioner. As I’ve stated before, it is generally the doctor’s training and experience that will dictate whether they are qualified to give a differential diagnosis in a particular case instead of the area of specialization that they may have. This is due to real life experience and different fellowship as well as the overlap of training areas.
Depending on your injuries, the doctor’s exam, your history, history of present illness and the diagnostic studies, your treating physician may refer you to a surgeon to determine whether you are a surgical candidate. Your treating doctor may suggest you be a candidate for surgery; however your treating doctor if they are not a surgeon, is not qualified to make this determination. Generally surgeons conduct their own exams, do their own history of present illness, and review the MRI’s and X-Rays themselves. If they are going to do surgery they want to make sure they are not relying on somebody else’s opinion but their own conclusions from test they have conducted and reviewed. Additionally, some surgeons are more conservative than others. Some surgeons feel that under certain circumstances a surgery is reasonable and medically necessary. Other doctors may review the same test results and suggest the patient wait and still other doctors may simply not want to do the surgery at all. Thus, you may not want to seek one surgeon’s opinion, but more than one surgeon to make a decision on the treatment that is best for you and your specific injuries. We highly stress you get more than one opinion before having any surgery so that you get a range of perspectives and opinions regarding different options.