According to a recent article in The Wall Street Journal, What if the Doctor is Wrong?, increasing evidence supports that second opinions from qualified physicians can lead to significant changes in a patient’s diagnosis or in proposed treatments.
Diagnostic errors are common. A study published in the BMJ, found that diagnostic errors in U.S. intensive care units appear to cause 40,500 deaths every year. Which is why it is so important to get a second opinion if you receive a serious diagnosis, require surgery, if your test results are inconclusive, or if you aren’t getting better from treatment. But keep in mind that you don’t need a second opinion for everything.
Certain cancers, for example, can be difficult to diagnose. Take Debbie, for instance, who had an annual mammogram and ultrasound and was told her results were clear. One month later she did her own monthly, self-breast exam and found a lump. Debbie was then diagnosed with stage 1 breast cancer and was treated with radiation and chemotherapy.
Which leads me to just how important your role as a patient is in contributing to an accurate diagnosis. Many of us think that if tests are done, then the results are accurate as is the diagnosis. Not necessarily so, according to Thomas Freeley, vice president of operations at MD Andersen Cancer Center, who said that 25 percent of patients who arrive at the center with a diagnosis for certain cancers may receive a different diagnosis.
The Harvard Medical Practice Study reported that diagnostic error accounted for 17 percent of preventable errors in hospitalized patients.
So, why do diagnostic errors occur?
- Pathologists and radiologists can misread slides and scans or fail to use the latest tests or technology.
- Medical providers arrive at an inaccurate conclusion about what is wrong with the patient.
- “Premature Closure”—a failure on the part of the physician to consider all possible diagnoses.
- Patients do not provide complete health summaries or medical histories.
- Tests can be inaccurate.
As someone who lived with severe, lower abdominal pain for 16 months and received 10 misdiagnoses from 11 physicians of differing specialties, I understand just how easy it is to receive a misdiagnosis. The last doctor I saw, a highly respected, medical school-affiliated, hernia specialist and surgeon, got it right—she diagnosed me with an inguinal hernia with a nerve passing through the hole and a muscle tear in my C-section site with nerve involvement. Three-hour surgery cured me and I’ve been pain free for 2 ½ years.
But some aren’t so lucky and are misdiagnosed and given treatments that cause even more problems.
As a Patient, What Can You Do?
1. Come prepared to the appointment with your physician armed with a diary of symptoms. List when they started, what makes them worse or better, what time of day they occur, if pain is involved, and more.
2. Make sure your doctor has your complete medical history. If not, create your own. List major medical events over your lifetime such as major surgeries, treatments, major illnesses and more. Include the year each occurred. (Remember my diagnosis that related to my C-section?)
3. Create a list of your current medications and their dosages, over-the-counter medications, herbs and supplements, and allergies to medications. Bring this list to every medical provider you see.
4. Obtain copies of your medical records that pertain to your current condition, such as lab tests, CT scans, MRI, etc. Bring pertinent records to your appointment with your doctor.
5. Create a list of questions for your doctor and speak up.
6. Once you’ve been given a proposed diagnosis, respectfully and politely ask your physician how he/she arrived at that diagnosis and if there are any other possible diagnoses.
7. Follow up on test results. Call your doctor and ask for the results if you have not heard back.
8. If something does not add up or if you are not getting better from the proposed treatment, ask that your tests be re-read by a different specialist.
9. Get a second opinion from a board-certified specialist who is affiliated with a respected medical school.
For more information, please visit www.thetakechargepatient.com