Inspect your patients’ skin!
Whatever a patient is complaining about, inspect the area of concern! You know how many times I have made an easy diagnosis simply by lifting a shirt and taking a look?
If a patient is complaining of abdominal or back pain, take a look at their skin. I have picked up shingles on a patient’s abdomen multiple times when that morning they went to the ER and had a negative abdominal pain work up (CT, labs, etc.). The patient underwent an expensive and unnecessary work up for shingles… I bet they documented the skin was without rash too.
Same goes for back pain. Unnecessary prescriptions, x-rays, CT scans for a severe back pain complaint when all it was shingles…
This is also common with headaches. Take look at the persons scalp! Inspect and palpate it. Sometimes you can find a rash to explain the pain! I have seen folliculitis, shingles, and cellulitis which explained the headache on numerous occasions.
Sometimes we forget to do this elementary health assessment and it ends up biting us in the ass. So remember, always inspect the skin!