Misdiagnosis

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Misdiagnosis

Postby NHE » Sun Apr 21, 2013 4:05 pm

The People's Pharmacy asks "Have you been misdiagnosed?"
http://www.peoplespharmacy.com/2013/03/ ... diagnosed/

Missed diagnoses are harming or killing 150,000 patients every year. How can so many avoidable mistakes be happening?

Most of us go to a doctor or hospital because we are having a problem. If a symptom is causing us a great deal of discomfort or if it does not go away after a reasonable amount of time, chances are that good that we will want a health professional to figure out what's wrong and come up with a treatment strategy that will help us recover.

Diagnosis is one of the most fundamental skills a medical student is supposed to master and then hone as a resident and practicing physician. We assume that all those arduous years of training have prepared doctors to figure out exactly why we are having symptoms. How well do they do at this essential task?

We were shocked to learn a few years ago that the answer to this crucial question is not very well. Even worse, it is a third rail issue. Researchers hare steered clear of this controversial topic. Professors in medical schools, hospital administrators and government regulators have pretty much ignored the problem. But in 2009 David Newman-Toker, MD, PhD and his colleague Peter Pronovost, MD, PhD, blew the lid off this scandal with a groundbreaking article in the Journal of the American Medical Association titled, "Diagnostic Errors--The Next Frontier for Patient Safety."

In this research they revealed that "an estimated 40,000 to 80,000 US hospital deaths result from misdiagnosis annually." During a radio interview with us they subsequently confided that the number published in JAMA was probably low and a more realistic figure was more likely 100,000 hospital deaths each year from missed diagnosis.
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Re: Misdiagnosis

Postby ljelome » Mon Apr 22, 2013 3:14 am

So how do we know for sure we have MS?...While there's so many other diseases that have similar features as MS, the clinical picture, the lesions, the symptoms...and there's no diagnostic tools that can give 100% diagnosis of MS accurately.

Especially where there's so little MS cases here, not sure if there's any doctor who know for sure about MS here, also so limited knowledge of DDMS.

What to expect here beside misdiagnosis?...Ouch...how i wish there's no pwMS here just a misdiagnosis because the lack of the doctors' knowledge about it.
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Re: Misdiagnosis

Postby centenarian100 » Mon Apr 22, 2013 11:00 am

NHE wrote:Diagnosis is one of the most fundamental skills a medical student is supposed to master and then hone as a resident and practicing physician. We assume that all those arduous years of training have prepared doctors to figure out exactly why we are having symptoms. How well do they do at this essential task?


I assure you that all physicians on Earth and all future physicians will make incorrect diagnoses at least some of the time.

I don't think that diagnosis is something one can "master." Why would you assume that doctors will have 100% diagnostic accuracy just because they have years of training? That's ridiculous. Do you think that they are Gods?

The human body is not some sort of simplistic mechanical device that is fully understood. There are 12,420 ICD-10 codes for diseases (http://www.who.int/classifications/help ... index.html) which doesn't even come close to classifying all human diseases.

Also, diseases evolve over time and don't always cause stereotypic symptoms/signs in each patient.

Lets take a look at an example from the article:


"Several years ago my wife had a bad case of bronchitis. Our family doctor put her on an antibiotic. She felt better for a few weeks and then she started coughing severely again. We went back to the family doctor who is a great person and competent doctor. He was going to put her on another kind of antibiotic. I am an accountant and as an analytical person I asked him a sensible question which was 'Why is my wife coughing so much after going through a round of antibiotic. Shouldn't some more tests or x-rays be taken?'
"He thought over my statement for a minute and then ordered a chest x-ray. What the x-ray revealed was that my wife had a mild case of pneumonia. There was some fluid in the bottom of her lungs which showed up on the x-ray. The doctor then ordered her to stay in bed for several days and prescribed another antibiotic. Bed rest is mandatory for pneumonia whereas a person can be up and on their feet if they have bronchitis.
"If he had not discovered that she had pneumonia, she would have been on her feet and getting worse and worse. After that event whenever we went to the doctor he would ask me if I had any questions. He had a new respect for my observations/comments. He had almost made a wrong diagnosis which could have resulted in very serious situation for my wife."


Did it occur to you that perhaps the family doctor was totally reasonable in making a [perhaps retrospectively erroneous] diagnosis of bronchitis? Maybe she had no fever, productive cough, or physical exam findings suggestive of pneumonia. Do you expect physicians to order a chest x-ray on every patient with cough? Really? Do you want higher cancer rates and health insurance costs?

Also, there are many patients with "walking pneumonia" who don't require hospitalization or bedrest. I love how he implies that he saved his wife's life by questioning the doctor.

------

Health care professionals should try to focus on minimizing diagnostic errors, but the idea of eliminating them is absurd.

I've been misdiagnosed by doctors many times. If I'm unsatisfied, I vote with my feet. If you don't like your doctor or question a diagnosis, get a second opinion. If you don't like doctors in general, don't see doctors.
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Re: Misdiagnosis

Postby centenarian100 » Mon Apr 22, 2013 11:02 am

ljelome wrote:...and there's no diagnostic tools that can give 100% diagnosis of MS accurately.


Exactly. For instance, neuromyelitis optica was previously thought to be a subtype of MS but is now thought to be a distinct clinicopathologic entity-a "pure" antibody mediated autoimmune disease.
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Re: Misdiagnosis

Postby blossom » Mon Apr 22, 2013 10:09 pm

centenarian100 wrote:I don't think that diagnosis is something one can "master." Why would you assume that doctors will have 100% diagnostic accuracy just because they have years of training? That's ridiculous. Do you think that they are Gods?

'Why is my wife coughing so much after going through a round of antibiotic. Shouldn't some more tests or x-rays be taken?'
"-He thought over my statement for a minute and then ordered a chest x-ray.


do i think dr.'s are GOD? no i don't because God is patient and kind and "listens to us personally as individuals" he doesn't throw us in a bushel basket as if we're all the same. i'm sure there are many good dr.'s out there. BUT, other than 1, my experience "especially" with neurologists my impression is that the many i dealt with do think and want to play God. but, they don't listen to us or treat us as indivduals. once that diag. ms is put on you you're gonna go through hell and high water to get them to address other possibilities. they are da man what would we want this or that taken care of to see if it helps. heck, we're only living in this body-just shut up and do as they say. tell ya here's some med.'s and don't worry about the side effects we have other med.'s for that if the first med.'s don't kill you first.--And, i have walked away or rolled away.

the story you put up about the lady with the pneumonia--you're right the guy did not save the wife's life the dr. did. but, note: the dr. THOUGHT about this man's statement and ordered the x-rays.--------he didn't tune him out. he was listening not pretending to listen and fluff him off.
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Re: Misdiagnosis

Postby ljelome » Mon Apr 22, 2013 10:27 pm

Yes, doctor is not God, but i'm afraid there's many doctors out there who play as God because of their knowledge. But i believe there's still many good doctors out there too, we just have to look for one. A doctor who will tell us the truth about the meds (side effects), the one who has an open mind n keep learning about new things, the one who admits if he/she doesn't have anymore clue, the one who's not after materials only, the one who really cares about their patient's health...

Oh Lord, please send me one..
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Re: Misdiagnosis

Postby centenarian100 » Tue Apr 23, 2013 2:17 pm

blossom wrote:do i think dr.'s are GOD? no i don't because God is patient and kind and "listens to us personally as individuals" he doesn't throw us in a bushel basket as if we're all the same. i'm sure there are many good dr.'s out there. BUT, other than 1, my experience "especially" with neurologists my impression is that the many i dealt with do think and want to play God. but, they don't listen to us or treat us as indivduals. once that diag. ms is put on you you're gonna go through hell and high water to get them to address other possibilities. they are da man what would we want this or that taken care of to see if it helps. heck, we're only living in this body-just shut up and do as they say. tell ya here's some med.'s and don't worry about the side effects we have other med.'s for that if the first med.'s don't kill you first.--And, i have walked away or rolled away.


I've experienced the same issues. It's definitely a big problem. I hate arrogant doctors so much. I actually had the opposite problem as you where I was telling my husband's neurologist that he had MS for over a year before he agreed. And yeah...they seem to downplay some very serious side effects and I want say, "Easy for you to say! You're not the one who as to take the poisons!"
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