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Diagnosing misdiagnosis: Why is it so prevalent?

If you're a patient in a medical facility in Arizona or elsewhere, you no doubt are concerned and paying attention to what's going on around you.

Put another way: Most people want to know what those pills are that they are taking and why they were ordered.   Pre-op patients are looking for signs that their surgical team is zeroed in on the right malady and body part. Hygiene -- or lack thereof -- in the hospital environment is duly noted.

What about the most basic of considerations:  Why are you interacting with the medical profession? What is the diagnosis that now accounts for your presence at a clinic or hospital? 

Was it correct? 

Or, conversely, was it made in error, with your providers now being on the wrong track and inappropriately treating you?

And, if the latter case is true, how prevalent is diagnostic error in the United States?

A recent article in The Washington Post indicates that medical misdiagnosis is a truly outsized and seemingly intractable problem in American facilities. That article spotlights a report recently issued by the Institute of Medicine, which cites the possibility that diagnostic error is inflicted upon "at least 12 million adults each year."

That is a staggering figure, and one that flags broad-based industry concern. It is also worrisome because of the many contributing factors underlying error that make improvements challenging.

Doctors sometimes do not communicate well with each other or interact efficiently with the new electronic health records systems. Patients do not always speak up and candidly discuss their conditions. Multiple departments might be involved with diagnostic tests and reports. There is constant time pressure.

The Institute of Medicine report states that sweeping changes are necessary in the medical industry to make material inroads on the misdiagnosis problem. There needs to be better collaboration among doctors and patients. Doctor-to-doctor feedback needs to be actively promoted. Electronic record systems must be improved. Teamwork needs to be emphasized.

And, perhaps most centrally, systems need to be implemented that routinely tag error and so-called "near misses" and disseminate such information in a non-punitive way that does not threaten doctors.

The Institute's President Victor Dzau says that the high level of diagnostic error occurring in the United States "cannot and must not continue."

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