Chances are shockingly good that you will be misdiagnosed by at least one doctor sometime during your life. That’s the conclusion of a blue-ribbon panel of experts from the prestigious Institute of Medicine (IOM).
The new report from the IOM suggests that virtually every American will experience a diagnostic error at some point. The respected medical experts estimate that mistakes in diagnosis cause up to 17 percent of hospital complications.
It may not seem like such a big deal, but a mistaken diagnosis can have tragic consequences. The IOM report notes that:
“Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions.”
What is the Institute of Medicine?
To understand the significance of this report you have to know that the Institute of Medicine is one of the most prestigious medical organizations in the world. It is made up of the country’s most renowned researchers and clinicians.
Reports from the IOM are objective and evidence-based and serve to guide policy-makers and health professionals. When the IOM states that health care is dealing with a huge problem of diagnostic errors you can believe it.
Why You Should Care About Diagnostic Errors
The IOM report notes that mistakes in diagnosis contribute to 10 percent of patient deaths. That makes diagnostic errors one of the leading causes of death in this country. Some experts believe that misdiagnoses in hospitals lead to 100,000 deaths annually (revealed by Peter Pronovost, MD, PhD, on the People’s Pharmacy radio show, March 24, 2010).
Others think the number is closer to 200,000 deaths in hospitals. That does not take into account out-of-hospital mistakes. The IOM concludes that 5% of all ambulatory care doctor visits results in a misdiagnosis. That means over 18 million diagnostic errors are made by primary care providers in the U.S. each year.
If these numbers are true, that would make misdiagnoses the third cause of death in the U.S., right behind heart disease and cancer. Billions of taxpayer dollars are spent on electronic health records, research into diseases like asthma, cancer and heart disease. The government has budgeted almost nothing for solving the epidemic of diagnostic errors.
Misdiagnosed–A Silent Epidemic:
Despite the importance of diagnostic errors, they are difficult to measure, in part because of lack of transparency. One study queried 1,891 doctors about their attitudes regarding honest communication with patients. We found this shocking but not surprising: “Overall, approximately one-third of physicians did not completely agree with the need to disclose serious medical errors to patients…”
The Wrong Diagnosis Can Be Devastating:
So far we have been discussing big numbers and theoretical problems. It is hard for most people to understand what can happen as a result of misdiagnosis unless they have been directly affected. Let us tell you about the unbelievable story of Neil Spector, MD.
Dr. Spector is one of the country’s leading research oncologists. He has developed important anti-cancer drugs and leads a team of top researchers at the Duke Cancer Institute. He is one smart doctor, but when Dr. Spector developed strange symptoms in 1993 he relied on his physicians to diagnose his symptoms.
At the time, Dr. Spector had recently moved to Miami from Boston. Shortly after the move he began experiencing irregular heart rhythms. Although he was a long-distance runner in great shape he also had bouts of severe chest pain. Other symptoms included fatigue, muscle aches and episodes of brain fog.
Doctors chalked up his diverse symptoms to stress. Even though the problems persisted over several years the diagnosis kept coming back from various physicians that everything was psychological.
Eventually the cardiac condition became so severe that a pacemaker was implanted. That helped a little but Dr. Spector’s heart eventually failed almost completely. One Friday a heart surgeon told him that he needed a heart transplant or he would be dead by Monday (hence the title of his book: Gone in a Heartbeat: A Physician’s Search for True Healing).
Fortunately for Dr. Spector he did get a heart transplant in the nick of time and he has recovered. The source of his downward spiral and heart failure: Lyme disease. For years he was misdiagnosed. The mistake almost killed him.
What Can Patients Do to Prevent Being Misdiagnosed?
If a brilliant physician like Neil Spector could go misdiagnosed for years, what hope is there for the rest of us? The IOM report has a long list of recommendations for doctors. It encourages teamwork and more patient and family involvement in the diagnostic process. The report also promotes better professional education and technology to aid doctors in diagnoses.
We applaud these suggestions, but fear many physicians still believe diagnosis is their domain and patients should accept their decisions. That is partly how we got in this predicament to begin with.
We have been concerned about diagnostic errors for years. That is one reason we wrote the book, Top Screwups Doctors Make and How to Prevent Them. We have three chapters devoted to misdiagnosis in this work. You will learn the most common conditions that are misdiagnosed (hint: adverse drug reactons, blood clots in lungs and cancer are among the top problems). You will also find out the top 10 reasons why doctors make diagnostic errors. Most importantly, learn about 10 critical questions to ask your doctor to reduce diagnostic disasters (hint: one important question may be, “what else could it be?”)
Here is a link to our book. It just might save your life or the life of someone you love.
You may also wish to listen to our radio show #1007, in which our expert guests, including Dr. Spector, discuss the importance of disclosing diagnostic and other errors.
Share your own story below in the comment section. Have you ever been misdiagnosed? And please take a moment to vote on this article at the top of the page.
