If you weren’t aware of the prevalence and severity of diagnostic errors, (misdiagnosis, missed diagnosis, delayed diagnosis) you might be now.
The Institute of Medicine (IOM ) released a new report called, Improving Diagnosis in Health Care. The report cited that most people will experience one or more diagnostic errors over their lifetimes. It also revealed that diagnostic errors contribute to 10 percent of patient deaths and account for up to 17 percent of hospital adverse events. But because of a scarcity of reporting and research on diagnostic errors, those numbers might be very conservative.
According to Mark Graber, MD, president of The Society to Improve Diagnosis in Medicine, diagnosis is wrong 10-15 percent of the time.
It happened to me. 10 times to be exact. During a 16-month long, severe chronic pain condition, I received 10 misdiagnoses from 11 physicians with different specializations. Along with the 10 misdiagnoses came 15 procedures and tests. Luckily, I found my own diagnosis in a New York Times article, In Women, Hernias May Be Hidden Agony
The surgeon and hernia specialist featured in the article, Shirin Towfigh, MD, diagnosed me correctly. She performed 3-hour surgery to repair a muscle tear in my C-section site and an inguinal hernia with a nerve pinched in the hole. I’ve been pain free for over 4 years and I am very grateful to her.
Some aren’t so lucky. Take Rory Staunton who was misdiagnosed in the ER with an upset stomach and dehydration. He died from severe septic shock brought on by a bacterial infection. There are countless others whose cancer or heart attacks were completely missed or misdiagnosed as innocuous ailments.
Arriving at a diagnosis can be an allusive process, not always easily uncovered through physical exams or tests. What contributes to misdiagnoses or missed diagnoses? See the Society to Improve Diagnosis website for causes.
The IOM report produced a number of recommendations for clinicians and insurers to improve diagnosis. It also emphasized patient and family collaboration with doctors. Since patients and their loved ones are such an important part of the diagnostic process, it’s essential that you know what you can do to help improve your chances of receiving an accurate diagnosis.
Here is where you come in.
As a patient, you are in partnership with your doctor. To be an effective team player you need to be an active participant in your care, not simply a passive recipient. If you aren’t feeling well enough to be proactive and form a mutual collaboration with your doctor, ask a loved one to assist. For more information on how to do this, please see my book, The Take-Charge Patient.
Free Patient’s Toolkit see here http://thetakechargepatient.com/patient-tool-kit.html You do not have to input any personal information for the free download.
Tips to Help Ensure an Accurate Diagnosis
- Before you see your doctor, create a symptom diary. Document your symptoms in a notebook, on your smart phone or other electronic device. Answer these questions:
- What are your symptoms?
- Where are they located?
- What makes your symptoms worse or better, such as exercise or eating a meal?
- Time of day your symptoms are better or worse?
- What you have tried to alleviate your symptoms? Did they help or not?
- If pain accompanies your symptoms or pain is the symptom, track it. On a scale of 1-10, 10 being the worst, document it every day.
- Bring your symptom diary with you to see your doctor and enter into a dialogue with him/her.
List of Questions Before You See Your Doctor
Create a list of questions before you see your doctor. This allows you to think about what you need to focus on. Document the answers and pieces of the conversation you believe are important.
You Are Given a New Diagnosis
If you are given a new diagnosis from your doctor, consider asking these questions:
- What is my diagnosis and what does it mean?
- Are there any other possible diagnoses for my symptoms?
- How did you arrive at this diagnosis? I.e.: test results, physical exam, radiology report, etc.
- What is my treatment plan?
- When do I follow up with you about my treatment plan?
If You Suspect a Misdiagnosis
If your treatment is not helping your symptoms, discuss it with your doctor. It’s possible that there is an alternative treatment that might work better for you.
- Ask your doctor if it’s possible that you might have a different diagnosis.
- Work with your doctor.
Ask That Tests Be Repeated or Read by a Different Clinician
Tests can be wrong or they can be read incorrectly. Ask that tests be done a second time or read by another doctor. Many doctors read reports given to them by radiologists regarding any imaging studies you’ve had. Ask that your doctor or another doctor read those tests.
Get Copies of your Medical Records
Obtain copies of your pertinent tests such as MRI, CT scan, X-ray, blood test results, surgery/op report. You should have all of these anyway in a health file at home, but if you don’t, simply make the request. You might have to sign a form or pay a small fee. Bring your own copies of tests to each new doctor you see.
Get a A Second Opinion
Patients are sometimes afraid to get second opinions. Please don’t be. It is your right and should not offend any medical professional.
- Ask a doctor you respect and have confidence in to recommend a specialist.
- Ask an RN or other healthcare professional for a recommendation.
- Ask/email your loved ones, colleagues and any physicians you know for a respected physician to see for a second opinion. You will see some of the same names recommended.
Every Time You See a New Doctor
Bring all the items listed above with you to each and every medical appointment with a new doctor. Take notes while you’re there.
Bring a Loved One with You
It’s not easy for anyone to hear, much less remember correctly, what a doctor says. Especially if you aren’t feeling well. Bring a loved one with you to each appointment with a doctor. Ask that person to take notes. You can review the information with that person at a later time.
Research a Diagnosis
If you are informed about your diagnosis, you will be better prepared to ask questions. To research a diagnosis go to credible websites such as:
- medical school websites.
- medical society or academy websites.
- disease organization websites.
- government websites.
Googling symptoms and diagnoses can easily lead you to inaccurate information and scary stories.
My Patient’s Toolkit is here. http://thetakechargepatient.com/patient-tool-kit.html Free download. You don’t have to input your email address or contact information. It is free to you to use at your leisure.
For more information, please visit www.thetakechargepatient.com