Washington – A report made by the Institute of Medicine showed that most people will experience at least one wrong diagnosis, a mistake that could lead to devastating consequences.
At the Institute of Medicine committee held on Tuesday, doctors agreed that getting the right diagnosis at the right time is essential, though it does not get the right attention.
The report suggested that 4 percent of adults who seek health care annually experience a diagnostic error, becoming the leading type of paid malpractice claims. These errors double the risk of resulting in a patient’s death compared to other claims.
“Many of us had experienced what we would define as a diagnostic error,” said Dr. John Ball of the American College of Physicians, who chaired the IOM committee, referring to the IOM committee’s medical specialists.
There are several reasons why a doctor could miss a diagnosis: rushed visits, unclear communication with patients, misread or misplaced X-rays or lab tests, electronic health records that can’t be easily shared, among others.
What can be done about it?
During the committee, doctors discussed the solutions this malpractice could have. According to Dr. Ball, “Patients are central to a solution.” Health providers – doctors, lab workers and nurses – should work together with the patients and encourage them to ask if the disease they are diagnosed could be something else.
Dr. Christine Cassel, president of the National Quality Forum, said the only way health providers can really learn from their mistakes is by telling them the mistake they made. Instead of considering it an embarrassment, it should become a norm that the patient’s third doctor calls the others if he or she finds an error in the previous diagnosis.
“We don’t expect the doctor to have all the answers in their brain. Nobody could or should,” Cassel said, adding that providers should make use of technology such as “decision support” tools that list possible alternative diagnoses to check.
Dr. Art Papier recommended the use of VisualDx, which is one of the “engineering tools to help the doctor think things through in real time.” This tool matches symptoms to a visual library of possible diagnoses and even counts with premium discounts to policyholders who use it.
Is it really that bad?
Diagnostic errors sometimes are so devastating they make it to the headlines. This is the case of Thomas Eric Duncan, a Liberian man who was diagnosed as having sinusitis while he was actually suffering from Ebola. Two days later he came back to the hospital and eventually died.
In the IOM committee, doctors mentioned the case of a woman who was criticized for questioning her doctor after being diagnosed with acid reflux when she truly had a heart attack. She ended up having serious heart damage by the time she returned to the hospital.
Other times, patients may not know they have been misdiagnosed. Sometimes cancer diagnosis is delayed because the doctor never called with the results of a pathology report.
“This is not about blame. It’s about understanding how errors arise and what we can do to prevent them,” said Dr. Mark Graber of the Society to Improve Diagnosis in Medicine, which prompted the IOM study.