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Diagnostic errors: Did your doctor get it right?

We live in a society that likes technological solutions. Medical care, in particular, has added more and more elaborate machines and expensive tests in recent decades.

What is often overlooked, however, is the importance of human judgment. In medicine, good judgment is necessary to make accurate diagnoses. Far too often, however, doctors make diagnostic errors that harm patients - and not enough attention is paid to admitting those errors and learning from them to prevent other people from being harmed.

An important new research report by the prestigious Institute of Medicine seeks to change this by focusing on the critical activity of diagnosis. In this post, we will inform you about what the report found and explain why it matters so much.

How often do doctors miss making the right diagnosis?

A high-profile example of a missed diagnosis is not hard to find. Last year, a Liberian man with Ebola virus disease went to an emergency room in Dallas. He was misdiagnosed with sinusitis and later died.

It is scary that an incident like that could happen, because Ebola is such a nasty and lethal disease. But in some ways the widespread frequency of diagnostic errors is even scarier.

How common are diagnostic errors? The report by the Institute of Medicine (IOM) did not attempt to give an exact figure. But the IOM estimated that at least 12 million adults are affected by mistakes in diagnosis every year. The report's authors used the word "pervasive" to describe the frequency of these mistakes.

What is it about the diagnostic process that is so flawed?

The point of the IOM report was not merely to deplore bad judgment calls by individual doctors. The problem of misdiagnosis or failure to diagnose goes far beyond that. After all, modern medicine is a highly complex enterprise, with thousands of possible lab tests and thousands of conceivable diagnoses.

Getting a diagnosis right amid all this complexity can be challenging. But it is made more difficult than it needs to be by the tendency in medicine's historically top-down culture for medical professionals to not communicate well with either patients or each other.

The importance of patients speaking up

It isn't only that medical providers are reluctant to admit errors to the public and to colleagues. There is a lack of collaboration across the board, starting with a lack of input from patients.

For example, the IOM report tells of an incident in which a woman showing heart attack symptoms came to the ER. When the doctor said she had acid reflux, the woman asked questions - only to be told by a nurse to stop doing so. But the woman really did have a heart attack and had to return for treatment on a blocked artery.

The proliferation of information technology is also a factor in the culture that produces so many diagnostic errors. Many medical professionals struggle to use the new electronic records systems, and this can distract them from focusing on the patient in front of them and making a good diagnosis.

If you believe a doctor has dropped the ball on diagnosing your condition accurately, don't hesitate to speak up. That ball gets dropped a lot and you are not alone.

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