Posted by Bill Sandweg on 24 January 2022.
Misdiagnosis is the most common form of medical malpractice and it very often results in death or serious injury. A 2012 review of 45 years of high quality medical literature, which was published in the BMJ Journal Quality and Safety, estimated that over 40,000 patients die in the ICU in the United States each year due to misdiagnosis. Vascular events and infections led the list of misdiagnoses. Not only is this a very large number, it is particularly high given the high level of professional care found in the typical ICU. If even these medical professionals are routinely misdiagnosing their patients, what can we expect from less well-trained and less experienced doctors and nurses. The level of misdiagnosis in the ICU has powerful implications for the number of misdiagnoses of patients who never make it to the ICU. Many researchers estimate that fully 20% of all cases involve some form of misdiagnosis, a number that far exceeds surgical errors and drug errors as causes of serious injury and death.
The consequences of misdiagnosis are many.
One of the results of misdiagnosis is the money spent on medical care that will be of no benefit to the patient because she does not have the disease the care is intended to treat. In the United States in any given year, wasted medical care costs billions of dollars, dollars that could have been used to actually treat illnesses and cure patients.
When a patient, who has been misdiagnosed, undergoes unnecessary medical treatment, more than money is wasted. The patient’s time and even health are also wasted. Sometimes the unnecessary treatment is surgery. Sometimes it is a medication that has serious side-effects for the patient taking it. The unnecessary treatment may result in serious health issues for the patient or even death. There is almost always an emotional toll when a patient undergoes medical treatment, whether it is needed or not.
Of course, the other side of the misdiagnosis coin is that the true cause of the patient’s problems, the problems that brought the patient into the health care system in the first place, are going unrecognized and untreated.
Misdiagnosis just never seems to go away. Regardless of the changes in medicine, including the development of newer, more accurate tests and better ways of imaging the body, doctors keep diagnosing illnesses that do not exist and missing ones that do. Of course, the reason is that diagnosis is an art. Some doctors do it much better than others. Often, the reason is that the really good diagnosticians are really good listeners.
I have heard more than once that, if you listen carefully, the patient will tell you what is wrong. If you are impatient or if you are prone to leap to conclusions, you will make a lot of mistakes in diagnosis.
For the patient, it really helps if you have a common disease because the impatient doctor is most likely going to choose your diagnosis from a list of pretty common ones she or he has seen frequently in the past. Patients should always think about getting a second opinion, especially if the condition being diagnosed is one which requires surgery or complicated, risky treatment. If you don’t get well after your diagnosis and treatment, you should also be thinking about getting a second opinion. If you are going to get a second opinion, look for someone who has a reputation as a good diagnostician.
The best advice I can offer on the subject of misdiagnosis is to know that it exists and that it is not at all uncommon. Don’t believe everything you are told, even if it is a doctor who is telling it to you.
