Thursday, November 15, 2012
Improve Diagnosis in Medicine.
Diagnostic Errors in Medicine; We’re talking about it now!
We now have something else to talk to patients about when it comes to medical errors. Diagnostic errors.
I had the privilege this week to speak at Diagnostic Errors in Medicine (DEM) Conference at Johns Hopkins University, Baltimore. There was a new group launched called Society to Improve Diagnosis in Medicine. Their mission; We envision a world where diagnosis is accurate, timely, and efficient.
I took this from their website; “Diagnostic error, defined as wrong, missed or delayed medical diagnosis, occurs in 10-15% of cases, leading to immeasurable harm and billions in inappropriate medical costs. These errors are also the largest contributor to total medical malpractice payments”
So what can we learn from this? The conference leaders brought in many different speakers who have experienced diagnostic errors as well as medical professionals willing to talk about them. We learned from the patient’s perspective that the doctor isn’t always right. For hundreds of years we have been asking the doctor what’s wrong and we expect the answer and the treatment to make us well again. We are now learning (I have known this but now the docs have let the information out) that we should probably be asking the doctors his / her advise and then we make a sound judgment , after gathering all the facts on what needs to be done.
I spoke about communication and how body language plays a big role in our sharing, or not sharing of information. If we don’t feel comfortable sharing, we may forget to tell the doctor something to help with the diagnosis. Do we understand the explanation about our treatment? Maybe not. It is not low literacy as someone insisted to me. It is poor communication, usually on the clinician’s part.
One researcher insisted that she can tell who patients are with low literacy because of how they struggle to put sentences together. I suggested that many people with low literacy have a very sophisticated vocabulary and have used that as a tool to cover their lack of reading skills.
Many people have heard about a misdiagnosis. It can be a stomach ache that was actually an enlarged appendix that burst, or a deadly ectopic pregnancy where the doctor tells the patient to take an antacid. A patient who has a misdiagnosis that a painful infection is a rash or being told that there is (or isn’t) cancer when the tests, which went unread, or were misplaced were the basis for lack of communication.
Rory Staunton’s dad was there talking about his son’s misdiagnosis of an infection. Rory was in deep pain following a scratch at gym during school. At a New York hospital they didn’t wait for the lab results to come back showing he was compromised and soon after Rory died from an undiagnosed infection that got into his blood stream.
It’s easy after the fact to say what the family should have done but we, the patient don’t always know that doctors make mistakes. It’s up to each one of us to now know that.
The following morning after Mr. Straunton spoke about his son, he sat with me at breakfast and told me some of his real feelings that he has as a dad. He used the words that I remembered using so well when my own son died years ago. It wasn’t only that his son died that is so painful but Rory died because his parents trusted the doctors to care for their child. That trust makes it much more painful. Ciaran Staunton shared stories about how wonderful his son was. How smart he was and caring he was about others. Rory, like many advocates can change the world. Sadly, he just won’t be here to see it.