Recently, a nurse practitioner at the Dartmouth-Hitchcock Medical Center informed me that I had a "classic case" of bronchitis my second in only a few months. I had been feeling sick for over a week at that point, so the prospect that someone could do something for my malady was thrilling, but I was concerned that I to go all the way to the hospital to find someone to do it. I had visited Dick's House already, only to be informed that my lungs sounded "very healthy" despite a hacking cough that kept me from sleeping at night. Clearly, this was the incorrect diagnosis, since the antibiotics prescribed to me at DHMC launched a speedy recovery.
I am not the only Dartmouth student with stories of misdiagnoses at Dartmouth's health center. One '13 told me that, despite his asthma, the nurses at Dick's House did not give him medication for a cough that developed into both bronchitis and a sinus infection. An '11 passed along a story from his sophomore year when his Dick's House doctor "laughed condescendingly" at the suggestion that he might have mono, only to discover that the test which the doctor only administered due to the student's protests came back positive. Two separate women on campus, a '10 and a '13, left Dick's House only to discover weeks later that they had walking pneumonia. The only people who didn't have major complaints about Dick's House were never very sick to begin with.
So what gives?
The answer may lie in the infirmary's methodology. Though the staff members at Dick's House are very nice and very friendly throughout the visit, the constant push to keep up with the flow of patients is an incredible constraint. An important aspect of their care system, therefore, is keeping patients who do not need their care out of Dick's House, using phone and online screening as tools to diagnose patients from home. While even with these measures there is still a high volume of patients, this attitude is successful in filtering out many students that do not need care. Unfortunately, though, it has the side effect of "over-filtering" students who actually need their help, and some students are told that they have the flu when they actually have a treatable illness.
Furthermore, it seems that even when students get appointments at Dick's House the doctors and nurses still overdiagnose the flu and underdiagnose other maladies. All of the students I spoke to told me that their diseases were dismissed as minor complications or after-effects from the flu. Though Dick's House employees were trained to be particularly sensitive to the flu this year as were all health care providers due to swine flu they certainly were not trained to dismiss very real complications as mere side effects. Dr. John Turco, director of College Health Services, said in an interview that there had been "relatively few" complications from the onslaught of flu this year. Clearly, this isn't the case, and it shows that Dick's House employees need to take student complaints more seriously.
If Dick's House looked into the number of students headed to DHMC for diseases they failed to diagnose, they would be stunned by what they found. And they are perfectly capable of checking those numbers. Copies of notes from the emergency department or other visits are sent to Dick's House so that appropriate medical follow-up can occur unless a student opts not to share this information. Turco estimates that this information is sent back to Dick's House over 90 percent of the time.
Dartmouth students have all had the flu before, and most of us can tell if we have the flu or something more serious. Though physicians must follow a certain set of guidelines and steps to attempt to make a diagnosis, they also must trust what their patients tell them. Just as they do not want us to waste their time on problems they cannot fix, we as a student body do not want to waste our time seeing a health care provider who will not treat our hacking coughs and sinus infections. Until the doctors and nurses at Dick's House begin taking these "minor complications" seriously, students will be forced to go off-campus to receive the care they need.
