We thank David DiSalvo, Medical Contributor to Forbes Magazine, for the following article:
A new study published in JAMA indicates that primary care doctors are increasingly missing diagnoses at the office, resulting in thousands of deaths and disabilities per year.
Researchers used electronic health records to track 190 diagnostic errors made during primary care visits at one of two healthcare facilities. In each of those cases, the misdiagnosed patient was hospitalized or turned up back at the office or emergency room within two weeks.
Pneumonia, heart failure, kidney failure and cancer each accounted for between five and seven percent of conditions doctors initially diagnosed as something else, according to a report in Reuters Health.
Dr. David Newman-Toker from Johns Hopkins University School of Medicine in Baltimore, who co-wrote a commentary on the new study, told Reuters: “We have every reason to believe that diagnostic errors are a major, major public health problem. You’re really talking about at least 150,000 people per year, deaths or disabilities that are resulting from this problem.”
Dr. Hardeep Singh, who led the new study at the Houston VA Health Services Research and Development Center of Excellence, added that most of the missed diagnoses were traced back to the office visit and the doctor not getting an accurate patient history, doing a full exam or ordering the correct tests.
Researchers suggest that patients can help improve the situation by coming to the office prepared to give their doctor all of the relevant information about the nature and timing of their symptoms. The study also points to the need for additional training for doctors to address deficiencies in initial and follow-on diagnoses.
“I do think it’s important for a patient to question or observe the doctor,” Newman-Toker told Reuters. “Ask pointed questions: ‘What else could this be? What things are you most concerned about?’”
Here’s a video presentation made last year by Dr. Brian Goleman called, “Doctors make mistakes: Can we talk about that?” that addresses the cultural pressures in the medical community that often result in shame and denial about the fallibility of physicians.
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