How Much Do You Trust Your Doctor?

Most people hstockvault-stethoscope129086ave experienced going to the doctor’s office when they are feeling under the weather.  We trust the doctor to find the solution to our problem so we can get back to our regular day to day activities.  Majority of patients just take what the doctor says at face value since we trust that they know best.  Should that still be the commonplace, especially when it comes down to serious illnesses when millions of people are being treated for the wrong medical conditions?  With viable clinical diagnosis support systems on the market, the use of these programs should be mandated by the government to save more lives.

Doctors are not perfect, they are subject to human error whether it be in the coordination of care between different providers or the misdiagnosis of diseases.  In a study done by the Journal of Patient Safety, they estimate that between 210,000 to 440,000 patients each year suffer preventable harm that leads to permanent damage or death.  In another study done by the Johns Hopkins Armstrong Institute for Patient Safety and Quality, by performing autopsies on deceased patients they discovered that 28% of patients have at least one misdiagnosis at their death.  Medication related illnesses and injuries due to prescribing errors have also risen by more than 50% in recent years.  These numbers are staggering and physicians should be trying their hardest to decrease this number.

However it can be argued that there are other factors that contribute to the number of misdiagnoses occurring that are outside of the doctors control.  Sleep deprivation or fatigue due to long shifts, especially among doctors who work in hospitals are one possible reason.  Doctors also work under time constraints that allot a certain amount of time spent per patient.  This could make certain symptoms easily overlooked if they are rushing from patient to patient.  Errors in record keeping done by nurses or other medical staff will have an effect on the patients’ diagnosis when the doctor looks at the chart.  Some of these factors are out of the physicians hands and come with the demands of the job.  It does seem counterintuitive that the people whose jobs can make the difference between life and death are one of the most sleep deprived jobs in America.

New technology is slowly being implemented in the healthcare system by a few doctors to try to find a solution to the problem.  One solution is the use of computers that automatically scan patient files and flags potential misdiagnoses or to prompt the doctors to follow up on test results, more office visits, etc.  At the Southern California Permanente Medical Group, they are using an automated program to survey the patients files.  In one of the first uses of their system, they identified over 25% of patients that were flagged for follow-up biopsies out of all the abnormal test results for prostate cancer.  Since implementing this system, they have not had any malpractice claims.

Another state of the art clinical diagnosis support system, Isabel has been developed to help provide physicians with a tool that lessens the chance of misdiagnosis.  In a study done by the US National Library of Medicine National Institutes of Health, they found that the Isabel program has a 96% correct diagnosis percentage.  This program was developed through funding by the Maude family after their 3 year old daughter was misdiagnosed and nearly died.  Isabel was diagnosed as having chicken pox when she actually had necrotizing fasciitis, a flesh eating infection.  By the time she was diagnosed correctly, so much damage had occurred that she is still undergoing plastic surgery at 17 years old.  Instead of filing a malpractice suit, they chose to devote their time and effort into developing a tool that would help prevent the same thing from happening to others.

In spite of the impressive correct diagnosis percentages, the use of computer programs such as Isabel are only slowly being integrated into the medical field.  Possible reasons are that most doctors don’t think that they need help diagnosing patients, especially with routine patient visits.  There is also the doubt that a computer system can make accurate decisions over human logic, experience, and knowledge.  Another argument is that it’s already too difficult to implement a new software system into an already busy work schedule.  The government is already mandating that all medical records to be turned into electronic format by 2014.  That in itself posed a challenge to some of the physicians who don’t feel the need for or see the value of electronic medical records.  By legally binding physicians to use a program that some feel they don’t need, or face financial penalties are sure to raise objections in the medical community.

In the news recently was the story of an 18 year old girl who died of a treatable heart condition, due to misdiagnoses by three different doctors who did not use a computerized diagnosis system.  With the universal implementation of new technology into most hospitals and doctor’s offices, hopefully the number of unnecessary deaths will decrease.  An excerpt from the Hippocratic Oath that all doctors take when they complete medical school seems to be fitting for this situation, “I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery….I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.” Doctors should remember their oaths instead of complaining about installing a new system or perceived hits to their own egos.  They should be more concerned about preventing tragic deaths like this one and the profound effect that it has on their families, young or old.

This brings home the point that not every diagnosis is correct, and getting a second or third medical opinion could help to save your life or others.  With better healthcare reform laws that mandate this technology, we can prevent the deaths of individuals who otherwise could’ve been treated.  Deaths due to misdiagnosis of diseases should not be the third leading cause of death in America, behind heart disease and cancer.  With statistics in the John Hopkins study showing that one in four patients are misdiagnosed, chances are that it could be happening to yourself or to someone that you know.

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One Comment to “How Much Do You Trust Your Doctor?”

  1. In this day and age it seems that people want the answers for everything instantaneously. Is there any sense of waiting anymore? I feel that most of these quick diagnosis that lead to misdiagnosis is because people are expecting answers right then and there. This puts tremendous pressure on doctors as well. I wonder what the ratio of individuals to medical doctors. If I had to guess I would think that it is quite slim. This also puts pressure on doctors to also quickly diagnose people in order to see as many customers as possible. I feel that the solution could be to motivate some of the younger generation to take up an interest in this area. The future ultimately is in the hands of the next generation. But how likely will this ever happen when our society shows more of an interest in absurd, useless things like Miley Cyrus and other celebrities?

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