Study: Misdiagnosis a major issue for doctors

Better communication and more transparency about past diagnostic errors could help to limit them in the future.

By Stephen Feller

WASHINGTON, Sept. 22 (UPI) -- Most people will experience at least one incorrect medical diagnosis in their lifetime, resulting in negative health outcomes, psychological distress and financial cost, according to a new government report.

Researchers at the Institute of Medicine, part of the National Academies of Sciences, Engineering and Medicine, said in the congressionally mandated report that medical diagnosis is a complex process that requires greater transparency in order to improve.


Because diagnostic errors are generally discovered in retrospect, researchers said more work needs to be done to improve medical teams and find ways to avoid errors that can be life-threatening in the long term.

"Diagnosis is a collective effort that often involves a team of health care professionals -- from primary care physicians, to nurses, to pathologists and radiologists," said John R. Ball, chair of the committee which wrote the report, in a press release. "The stereotype of a single physician contemplating a patient case and discerning a diagnosis is not always accurate, and a diagnostic error is not always due to human error. Therefore, to make the changes necessary to reduce diagnostic errors in our health care system, we have to look more broadly at improving the entire process of how a diagnosis made."


The researchers said there is not enough data on diagnostic errors, and efforts to improve diagnosis and reduce errors have been few and far between. The medical culture, they wrote, discourages transparency and disclosure of errors, making it more difficult to correct them.

The blame, researchers said, is most squarely placed on collaboration and communication between members of medicals teams treating patients, patients themselves, and their families. On top of this, researchers found the healthcare system is not designed for the collaboration needed in the diagnostic process and that diagnoses will continue to worsen if new ideas are not put forward.

The committee recommended more information, from electronic health records to test results, be made more easily available to families and caregivers, to help them better learn and understand what is going on with their health. Creating an environment for patients to question a diagnosis or add information about their condition could also help better inform diagnoses.

Healthcare organizations also need to encourage transparency and error disclosure by creating a non-punitive culture that embraces conversation about errors. In order to do this, organizations need to find ways to create a legal environment facilitating the timely identification, disclosure and learning from errors.


Most significantly, the committee said methods need to be established to make communication between physicians and specialists easier. Payers, such as Medicare or health insurance companies, should also consider a shift in emphasis from procedure-oriented care to a more cognitive style that emphasizes studying clinical histories, patient interviews and physical exams.

Doctors currently are not encouraged or paid to communicate as much as they should be, Ball told NBC News, explaining that radiologists and pathologists should be more involved in diagnosis because "there are 30,000 diagnostic tests -- 10,000 of those are molecular tests. No single physician can figure out which tests do I use on this particular patient."

The committee suggested a coordinated research agenda be crafted and mounted by the end of 2016 to work on improving the diagnostic process and limiting diagnostic errors.

The study is published by the National Academies Press.

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