Diagnostic errors in medicine are more common than often reported, or at least more common than you probably think. In fact, medical misdiagnosis is found in about 20 percent of all cases — many life-threatening.
The scary stats of misdiagnosis
A recent report by Kaiser Health News outlined the common, serious and potentially life-threatening occurrence of medical misdiagnosis. According to the report:
- 28 percent of 583 diagnostic mistakes reported anonymously by doctors were life-threatening or had resulted in death or permanent disability.
- A meta-analysis published last year in the journal BMJ Quality & Safety found that fatal diagnostic errors in U.S. intensive care units appear to equal the 40,500 deaths that result each year from breast cancer.
- And a new study of 190 errors at a VA hospital system in Texas found that many errors involved common diseases such as pneumonia and urinary tract infections; 87 percent had the potential for “considerable to severe harm” including “inevitable death.”
These statistics are indeed cause for alarm. Medical diagnostic error not only leads to wrong medical treatment and medication, but extension of the actual medical issue, lost time and out-of-pocket expenses, and potentially death.
The cause of medical misdiagnosis can stem both from the healthcare provider and the patient.
Healthcare provider error
Physicians and healthcare providers that are too busy, overworked and overly specialized can be prone to error in symptom interpretation and causal judgement. Just like with anything, we hear what we want and when something is outside our comfort zone, we can rationalize it back in.
Consumer Reports has an informative article on this very subject. In it they state:
“Then there’s the simple fact that doctors, no matter how brilliant, sometimes fall into certain ‘cognitive traps,’ says Jerome Groopman, M.D., who describes three pitfalls that can lead to diagnostic errors:
- Anchoring a diagnosis to the first bit of information provided by the patient and following a narrow path of thinking; for example, focusing on symptoms that suggest acid reflux and not considering that they could also stem from a serious heart problem.
- Connecting symptoms to similar complaints experienced by other patients who had less-serious problems.
- Letting stereotypes interfere with clinical judgment; for example, assuming that a patient with a disheveled appearance could have a drinking problem.
Patients need to understand that doctors are people, too, and thus prone to snap judgment and error. One of the best ways to help prevent quick judgment and error is to ask a lot of questions, and to offer a lot of information; even if it seems unrelated.
How to relate your medical issue
People generally describe the signs and symptoms of their pain, illness or health concerns in terms that they think the healthcare provider in front of them wants to hear.
For example, when facing their primary care physician they tell a story about issues related to the body like pain, itching, rashes and/or congestion. When meeting with their psychologist they may describe the same issue in terms of stress, anxiety, worries and how those things are connected. If meeting with a dietician they may try to relate a connection between what they are eating and drinking and the quality and level of their health concerns.
However, pain, illness and disease cannot be divorced from every aspect of a person. Wellness must be addressed utilizing a systems view of health. In other words, it must be addressed with the understanding that the whole of one’s life is greater than the sum of its parts and that a change in one part affects every other part. A rash is not just on the skin; it is a result of an issue in the body; a trigger and a response.
With this in mind, do your best to relate your health concern in as much detail and breadth as possible. Here are some tips to do just that:
- Be organized ahead of time. Sometimes when you’re put on the spot you can forget even the most annoying or worrisome symptom. Write important points down ahead of time that you need to communicate to your doctor. Don’t be afraid to bring your list on your visit. You’ll feel more confident talking with your doctor — and get his undivided attention.
- Be clear on your signs and symptoms. Take note of what type of pain you are experiencing (Is it a throbbing, stabbing or burning?); if you are fatigued, have insomnia, bowel issues, trouble eating — and if these symptoms occur with other events or actions, etc. Be prepared to rate your pain level on a scale of 1 to 10.
- Be sure to mention all related events, even assumed ones. This includes travels around the start of symptoms, arguments with family or employers, changes in appetite, sleep, bowel regularity, a walk in the woods. Don’t be afraid to offer too much information.
- Be mindful of your limited time with the doctor. Often healthcare providers are overbooked. So it is best to make your case at the onset and quickly… yet thoroughly (this is where your list of detailed symptoms will come in very handy). Be straight-forward with your communications. Holding out facts or spacing them out can lead to early judgment of diagnosis you want to avoid.
- Be empowered to push back and disagree. If you think the doctor is wrong in their assessment or simply not hearing you, don’t be afraid to respectfully speak up and say so. Your opinion is valuable. Ask questions and always feel empowered that you can say more or ask for more explanation or tests. You can also always get a second opinion.
When it comes to medical misdiagnosis, you don’t want to be on the wrong end of it. And while we as patients can’t control for what the healthcare provider we are seeing thinks or does or feels, we can bring our best game to the table. Having all the information together, even that which you might think irrelevant, can only help paint a broad picture from which the physician can make the best diagnosis possible.