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Diseases Doctors Miss Most

By: Medix team

Here are 5 disturbing examples of conditions that doctors often miss. Why does this happen and who's to blame?

When visiting our doctor, we all assume that getting a diagnosis and a treatment plan is a simple matter. Moreover, we take for granted that we were correctly diagnosed and that nothing was missed along the way.
Unfortunately, the reality of primary care visitations is quite different.
study published in JAMA Internal Medicine reviewed 190 medical records of diagnostic errors, in order to try and understand which conditions are often missed and why. Most of the diagnostic errors portrayed in the article had a significant potential for harm and complications. In fact, researchers at Johns Hopkins hospital estimate that more than one million people are hurt as a result of their doctors reaching wrong conclusions in America every year.
So who is to blame? Fingers tend to be automatically pointed at doctors as accusations of negligence and incompetence have become commonplace.  While doctors are an easy target, the situation is apparently more complicated than that, with healthcare systems, doctors and patients all carrying their share of the blame. 
From a healthcare perspective, primary care physicians regularly tend to large communities and therefore are swamped with appointments and are hard pressed for time. 
The article shows that most errors were related to a breakdown in the patient-practitioner clinical encounter. This means that the errors were due to data-gathering and synthesis problems (i.e. cognitive errors) when taking a medical history, physical examinations, ordering of diagnostic tests for further workup and failure to review previous documentation.
Two additional documentation-related problems were notable. First, no differential diagnosis was documented at the index visit in 81.1% of cases, a fundamental step in the diagnostic reasoning process. Second, practitioners copied and pasted previous progress notes into the index visit note in 7.4% of cases; of these cases, copying and pasting mistakes were determined to contribute to more than one-third of errors. 
Data-gathering and synthesis problems are not only doctor's responsibility.  In many cases, the patients themselves are at fault. This occurs when giving answers to sensitive or embarrassing questions is either sidestepped or when responses are sugar coated. Withholding important information isn’t always intentional, often patients don’t even know that the information that they are withholding is relevant to their problems. When potentially key details are missing from the clinical picture, it is no wonder that diagnostic mistakes are made.  
And then again, sometimes there is no one to blame. In approximately one-third of cases patients presented with symptoms that appeared to be unrelated to the missed diagnosis which could easily divert the practitioner's attention during the short span of the primary care visit.
Beware; here are the conditions that were found to be commonly overlooked:
  1.  Pneumonia
  2.  Decompensated congestive heart failure 
  3. Acute renal failure 
  4. Cancer (primary) 
  5. Urinary tract infection or pyelonephritis
Awareness is one of the best ways to avoid having a missed diagnosis. Human error exists in medicine the same way as it does in any other field which is why getting a second opinion is so important for ensuring that you are truly healthy. If at any point during or following a doctor’s appointment you are left with a sense of uncertainty, don’t hesitate to either ask for an expert medical consultation.

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