A new study shows that approximately 371,000 people die and 424,000 sustain permanent disabilities due to diagnostic error, including brain damage, blindness, loss of limbs or organs or metastasized cancer.
40% of these severe outcomes are linked to errors in diagnosing stroke, sepsis, pneumonia, venous thromboembolism (VTE), and lung cancer. These five diseases fall under the umbrella of frequently misdiagnosed major vascular events, infections, and cancers, known as the “Big Three.”
These numbers represent only a fraction of the roughly 12 million Americans who are misdiagnosed every year. While the chances of dying or sustaining severe physical harm due to diagnostic error are remote, misdiagnosis is a real issue, and in many cases, preventable.
Why diagnostic errors happen
Commonly, a life-threatening disease gets missed because its symptoms present as milder or less obvious. For example, dizziness and headache can be a sign of stroke, but they are also symptoms of less serious conditions. Other diseases, such as sepsis, which is the body’s severe reaction to infection, can be challenging to diagnose because the location of the infection is not always apparent. Comorbidities further complicate the diagnostic process. An immunosuppressed patient with sepsis may not develop fever and chills, despite those symptoms being typical of sepsis. These factors can delay administration of life-saving treatment, or cause a patient further harm resulting from receiving treatment for the wrong condition.
Diagnostic errors can also stem from healthcare providers not having a full understanding of a patient’s medical history. If a patient has seen a number of different care providers, records may be disorganized. Patients may misremember or forget important parts of their medical history.
Similarly, a patient may lose trust in a healthcare provider and withhold information if the quality of the provider’s care is clouded by implicit bias. Implicit biases are unconscious stereotypes an individual associates with a group of people, which subconsciously affect how the individual treats that group. For example, a healthcare provider may be biased to think that women exaggerate their pain, which may lead to misdiagnosing a female patient.
For people of color, implicit bias from practitioners is even more prevalent. Black people are less likely to receive pain medication from paramedics, due in part to racial stereotypes about drug-seeking behavior and high pain tolerance.
How can patients play a role in their diagnostic journey?
The diagnostic process is a complex and collaborative effort between a patient and their care team. The better information that is gathered, the more accurate and timelier the diagnosis will be. Patients can help their care team by keeping a good record of their personal medical history.
It is also important for patients to stay informed about relevant conditions, tests and medications. Following up with providers with any questions about any changes or next steps is another good way for patients to stay involved in their diagnostic journey.
How to decrease diagnostic errors
While implicit bias in medicine will always exist on some level, becoming aware of unconscious biases is the first step healthcare providers can take in learning to look beyond them. Errors will still happen, but by truly listening to patients and validating their experiences, effective and life-saving treatment can be rendered sooner.
