Don’t Be a Victim of Medical Errors – Part I – By Dr. Tunde Alaofin

Avoid Medical Errors - Doctor Shrugging

Medical misdiagnosis is one of the biggest healthcare safety concerns in the United States today according to The Institute of Medicine. In 2013, about 22 million Americans were misdiagnosed and over 100,000 died as a result (Leavitt & Leavitt, 2011).  Globally, misdiagnosis is responsible for millions of patient deaths every year. It is an immense and costly problem. Misdiagnosis also affects the economy by raising the already high price of healthcare delivery. The costs of an inaccurate or delayed diagnosis are very steep. It includes costs of late treatment, litigation, malpractice insurance payouts and the lost economic productivity of the patient. The dynamics of medical decision-making are changing in response to increased pressures on the global healthcare system. In developed countries, the amount of money spent on healthcare is typically the largest single component of gross domestic product (GDP) (Krugman & Wells, 2009).

The cost of healthcare influences the cost of insurance we all pay as well as government services for the uninsured. These rates will only continue to rise as baby boomers age and medicine becomes more and more advanced. Given the human and economic problems created by misdiagnosis, there is an added pressure to bring new efficiencies to the delivery of healthcare by creating an imperative for diagnoses to be made more quickly and accurately (Goldsmith, 2011). How would you measure the true cost to the person who loses their loved ones unnecessarily to medical error? This article is written to educate patients on some precautionary measures that can be taken so that they will not become victims of medical errors.

Why do diagnostic errors happen?

First, we should acknowledge that diagnosis is difficult, healthcare system is imperfect and, as human thinkers, doctors are fallible. . There are more than 12,000 identified diseases today according to the World Health Organization. Due to complexities of human body, one disease may manifest in ten different ways with ten different patients. This therefore make easy for doctors to misdiagnose patient.

Another reason is the complexity of the health system, communication barriers and disjointed care. In today world where people are so mobile, relocating from one city to another, patients change doctors like they change shoes and their medical records sometimes does not follow suit. In some cases, providers will not follow up with patients after health-care visits to encourage them to speak up and keep track of their health records. The tendency for medical error is very likely.

Research have shown serious ownership issues in that no one seems willing to take responsibility for misdiagnosis problem. It seems that diagnostic errors fall into our collective blind spot. Hospitals and health-care organizations think this is a doctor issue. Doctors think it’s a problem for other doctors, and educators don’t see it as their responsibility at all. This is why it’s so important that patients, as “consumers” of healthcare services, should be knowledgeable about their medical conditions with diagnostic tools.

There are some free medical diagnostic tools available to empower patients with the needed knowledge to make sense of their symptoms and change the way they speak to their doctors forever. In my next article, I will provide some empirical insights into how the use of these diagnostic tools can improve medical outcomes for patients.

Article By:

Dr. Tunde Alaofin

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Don’t Be a Victim of Medical Errors – Part II – By Dr. Tunde Alaofin

Avoid Medical Errors - Confused DoctorThere are five important roles patients should play to avoid being the victim of Medical Errors:

  • Get To Know Your New Partner –
  • Trust Your Health Care Professional
  • Educate Yourself
  • Take Control of Your Life
  • Speak Up

Get To Know Your New Partner

Isabel, a 3-year-old daughter of Jason and Charlotte Maude was misdiagnosed at a local hospital in England. Isabel spent two months in hospital, including a month in Pediatric Intensive Care Unit after experiencing multiple organ failure and cardiac arrest.

Isabel’s extensive suffering could have been avoided if the local emergency department and family physicians had stopped to ask ‘what else could this be instead of assuming her symptoms were typical of the chicken pox from which she was also suffering?’ Isabel was later diagnosed to be suffering from well-described complications of chicken pox: Toxic Shock Syndrome and Necrotizing Fasciitis.

Rather than suing the hospital for medical error or malpractices, Isabel Healthcare System was created, in honor of Isabel Maude and all patients whose lives have been impacted by missed or delayed diagnosis, to help clinicians around the world do the best job for their patients and to help patient make sense of their symptoms. Isabel – Symptom Checker software is one of the most powerful tools on the market that thousands of clinicians and patients rely on daily to produce a list of possible diagnoses on a timely basis (http://www.isabelhealthcare.com). I would encourage all patients to get to know this new partner and others like her in the marketplace.

Trust Your Health Care Professional

One of the most crucial element to reduce misdiagnosis is to collect the right data in time to make it part of the decision-making process. This means that patients need to provide accurate information to their medical providers. It is not uncommon for some patients to feel hesitant about sharing information. This is particularly true when this information could be embarrassing. Many of us have experienced seeing a doctor with what we feel to be an embarrassing situation. There is also a cultural component to this because, in some families, nationalities or genders, certain topics are considered taboo. These secrets can result in the doctors starting with incomplete information.

Doctors know this and will often make assumptions and come to different conclusions based first on the idea the patient is telling the truth and then a second potential diagnosis if the patient is not telling everything. Sometimes the withheld information can be as simple as the patient’s actual age, but it can even go as far as keeping secrets about drug use, medications taken, sexual history or previous illnesses. We need to remember that are physicians are trained to recognize patterns in symptoms and laboratory findings to generate a diagnosis.  It becomes more difficult when patients withhold information or present in an atypical fashion.  One of the goals of this article is to propose a unique approach to counter medical misdiagnosis by encouraging healthy partnerships between doctors, patients and intelligent software. When your medical provider pronounces a diagnosis, always get a second opinion.

Educate Yourself

Patient’s self-motivation is very important because we have human doctors making human decisions about other humans. Patients need to be aware of what may influence their doctor’s decision-making.  Imagine a doctor comes to conclusion about a diagnosis. The patient has disease X that requires drug Y. The doctor may be reluctant to use this drug, because a patient he prescribed it to previously had died. This could cause the doctor to revise and reject the rational process of attitude formation. It isn’t always about a negative bias towards a person. Sometimes it is about good doctors who are intimidated by a previous bad result. Thus, with the use of a free diagnostic tool like Isabel and patients self education, they will be able to provide inputs, clues, reminders, or extra eyes that can help a physician come to a more accurate diagnosis. Remember that the goal is to promote diagnostic partnerships between doctors, patients and intelligent software to help reduce misdiagnosis.

Take Control of Your Life

Patients need to stay informed about their bodies and symptoms. Doctors will continue to spend time learning, but when most doctors spend the bulk of their time with patients and only about five hours a month learning about new diseases, we need to be knowledgeable and present possibilities to them (Hafner, NYTimes). However, as Katie Hafner points out in her article For Second Opinion, Consult a Computer? computer software “can analyze the equivalent of thousands of textbooks every second.” That means that as awareness grows, technology improves and patients and doctors become more accepting, the incidence of misdiagnosis will become increasingly rare. All of this points to the continued need to be an informed populace and to encourage doctors to continue to work with all available tools in order to help reduce the rate of misdiagnoses. We all have a part to play.

Speak Up

Medical researchers conclude that the majority of diagnostic errors arise from flaws in physician thinking, not technical mistakes. The stressful atmosphere of hospital-based medicine contributes to a high level of anxiety. Knowing the right questions to ask and being good advocates is important. Sometime it can be difficult, particularly when there are perceived power imbalances in the doctor-patient relationship. This is where patient advocates may have a role. Patient must know how and when to give feedbacks about errors if their symptoms persist, change or worsen. Your life may just depend on it.

Diagnostic mistakes account for about 15 percent of errors that result in harm to patients, according to the Institute of Medicine. Yet diagnostic software has been slow to make its way into clinical settings, and Dr. Dhaliwal, professor of clinical medicine at the University of California, San Francisco who is considered one of the most skillful clinical diagnosticians in practice today, uses Isabel as a “second check,” said he could understand why.

Not only is it hard to integrate software into an already busy daily work flow, he said, but “most of us don’t think we need help at diagnosis, especially with routine cases, which account for the majority of our work” (Hafner, NYTimes).

The bottom line comes back to the theme of the article: “Don’t Be a Victim of Medical Errors”. Diagnostic software simply provides information for a physician to consider when working with a patient. It is the patient’s knowledge and the level of advocacy that these ideas, clues, reminders, or extra eyes that can help a physician come to a more accurate diagnosis.

Article By:

Dr. Tunde Alaofin