The Case of Misdiagnosis

Obtaining a correct diagnosis is an essential element in healthcare. A diagnosis not only provides the reasons for a patient’s health problem, but defines the very core of subsequent treatment, thus affecting the patient’s prognosis. According to a recent study published in a healthcare journal (BMJ Quality & Safety), in the US alone around 12 million adults are wrongly diagnosed, half of these diagnostic errors are potentially harmful to the patient.

Misdiagnosis – diagnosing a patient with the wrong disease (illness or injury included), or diagnosing the correct disease too late. The issue of misdiagnosis continues to be a large burden for not just the healthcare provider, but more importantly for the patient. Misdiagnosis includes diagnoses missed, delayed, or incorrect, which are usually spotted following further findings or testing. Misdiagnosis can even occur when despite being given the correct diagnosis, a doctor may fail to identify complications, or fails to identify a related or unrelated disease.

The effect misdiagnosis has on a patientWrong diagnosis, misdiagnosis

Misdiagnosis not only affects the patient psychologically and financially, but physically it may have a detrimental effect on their health. It can lead to delayed treatment (which may be urgent), inappropriate treatment (that may be harmful), or quite simply the patient not receiving treatment at all. The patient’s symptoms may exacerbate as they are not receiving the necessary treatment, ultimately their condition may worsen, and in some cases it may even be fatal.

From a legal prospective, holding the doctor responsible and proving medical malpractice proves a challenge. That goes to say, that many skilled doctors have and still do make diagnostic errors. Differential diagnosis is a systemic technique that doctors utilize to determine a disease or particular condition, it is based on medical observations to establish a number of potential diagnoses, of which many are ruled out as the medical investigation continues. Sometimes a doctor may not add the correct diagnosis on the list of potential conditions, or he/she fails to not perform further diagnostic tests to evaluate (the likely) diagnosis.

The causes of misdiagnosis vary and go far beyond the level of a doctor’s experience, an ineffective health care system miscommunication (or lack of communication) are also common. There are over 8,000 diseases that exist, so uncertainty is quite common during the diagnostic process. In addition, the diagnostic equipment could also be faulty (or lacking), or be due to human error of interpreting results. It is important for medical students to partake in training that would enable them to identify and minimize errors in diagnostics, and for doctors to continue to identify diagnostic errors and the reasons for them.

The incidence rate of misdiagnosis is higher in an emergency setting, mainly due to pressure in having to identify a condition in the shortest time possible; this includes stroke, appendicitis and heart attack. Generally misdiagnosis occurs if the patient has a rare disease or very common disease that has non-specific symptoms. More worrying common conditions such as myocardial infarction and pulmonary embolism are just some of the many misdiagnosed conditions. Of course taking into account that the types of misdiagnosis are dependent on the specialty type.

Misdiagnosis leads to mistreatment

Delaying proper treatment for cancer, could have a devastating effect on the health of a patient. It is well known that early detection of virtually any type of cancer is imperative to the treatment outcome. Misdiagnosis of a cancer patient could lead to a rougher, more grueling treatment approach, or in severe circumstances could kill a patient as the cancer spreads to other areas of the body (metastasized). Furthermore, delaying treatment in a cancer case increases the chance of recurrence (returning cancer). Misdiagnosis can also lead to unnecessary invasive biopsies that may cause more harm to the patient.

Many patients seek a second opinion following unsatisfactory results or no change in their health following treatment. Detailed below are 2 prime examples of patients who sought a second opinion at the leading private hospital in Israel Herzliya Medical Center:

Emanuel Adaji, came to Herzliya Medical Center (HMC) from Nigeria after his doctor diagnosed him with lung cancer. Upon his arrival, Mr. Adaji underwent blood tests and another CT scan; Professor Nir Peled, a world-renowned oncologist in lung cancer treated him, and ruled out lung cancer. Mr. Adaji choose to come to HMC for a second opinion, this changed his entire outlook on life and gave him a concrete diagnosis.

Furthermore, in another case HMC specialists prevented a patient from receiving a delayed diagnosis: William Metieh a 62 year old from Nigeria had undergone several PSA tests over several months, including a DRE to check his prostate following abnormally high PSA levels. Mr. Metieh decided to come to HMC for a second opinion. Doctor Daniel Kedar, a urologic oncology expert at HMC advised a biopsy following Mr. Metieh’s results – fortunately his results indicated that he did not have prostate cancer.

2 Ways to ensure a correct diagnosis and treatment

  • You can help your doctor - take special note of your symptoms (be able to describe them in specific detail), as well as your medical history and current medications. Once a diagnosis has been made, ask what you should expect and the red flags you should be looking out for, for example if the prescribed treatment had little or no effect, or you experience other symptoms these are warning signs that it could be something else or more serious
  • Second opinion – Take control of your health, don’t be afraid to ask your specialist as many questions as possible. If you are not satisfied or the treatment prescribed has so far been ineffective, consider getting a second opinion. Perhaps the specialist failed to conduct further tests, or missed out on essential information and/ or symptoms that could have pin-pointed to the reason or possible indication for your condition

Specialists at Herzliya Medical Center (HMC) work in collaboration with related specialists from other fields of medicine in order to maximize the diagnostic process. The specialists at HMC have years of experience and training, while continually investing in further training courses in their respective fields this ensures that no diagnostic errors will occur. Diagnostic equipment at HMC is advanced and cutting-edge, combined with innovative and diversified laboratory testing with added precision leaving little room for error. A patient’s full medical history is recorded and previous tests acquired from the patient are verified for further testing (if and when required), this ensures that invasive procedures and other diagnostics such as biopsies are only applied when deemed absolutely necessary. Contact HMC for a second medical opinion, or for all other diagnostic and treatment procedures.

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