A recent report1 issued by the Institute of Medicine (IOM) included an alarming statistic: 12 million adults in the U.S. who seek outpatient medical care experience a diagnostic error each year in the form of an incorrect, missed or late diagnosis. The report’s authors conclude that most people will experience at least one diagnostic error in their lifetime. What steps should you take to help prevent yourself from being misdiagnosed?
A significant problem that hasn’t received enough attention
While there have been several studies that have examined hospital and medication errors, there have been far fewer that have explored the problem of diagnostic errors. The studies that have been undertaken have found that the problem extends well beyond outpatient care and that these errors can lead to inappropriate treatment and poorer outcomes. For example2:
- 10 to 20 percent of cases are misdiagnosed
- 28 percent of cancer cases are misdiagnosed according to a study in the journal BMJ Quality and Safety
- 47 percent of clinicians encounter preventable diagnostic errors monthly
- one in four breast biopsies may be misdiagnosed
- 28 percent of 538 reported diagnostic errors were life-threatening or resulted in the patient’s death or permanent disability
- diagnostic errors contribute to 10 percent of patient deaths and 6 to 17 percent of hospital adverse events
What you can do to lower your risk of misdiagnosis
The IOM report included several changes that could help to reduce the number of diagnostic errors in all healthcare settings. These suggestions included making sure that all members of the healthcare team, including pathologists and radiologists, are integral parts of the diagnostic team, using technology that improves rather than impedes communication between members of the healthcare team and with the patient, and making sure that physicians and other healthcare providers get regular feedback on the accuracy of the diagnoses they make.
But the first recommendation on the committee’s list may be the most important—making sure the patient and family are actively and consistently included in the process of diagnosis from the start. Patients and their families have information that can be vital for healthcare providers working to develop a diagnosis, including previous personal and family health history and a complete description of the symptoms the patient has been experiencing.
To protect yourself from misdiagnosis, you should make sure you and your physician keep the lines of communication open. Answer all your doctor’s questions frankly and, if you don’t understand something your doctor tells you, ask for an explanation in plain English. It’s also important that you have a comprehensive and accurate medical record that can easily be shared by all the physicians treating you. That can help ensure that the results of diagnostic tests are reviewed as part of the diagnostic process and that any needed follow-up is scheduled in a timely manner.
It’s also important to come to your physician’s appointments well prepared. Before the appointment, make a list of your symptoms, how long you’ve experienced them and any questions you have for the doctor. It can be helpful to bring a trusted family member, friend or advocate with you to the appointment to take notes and ask questions, especially if you’re dealing with a serious health problem. By being an active participant in the diagnostic process, you’ll not only be a more informed patient, you’ll also lower the risk of avoidable diagnostic errors.