How to Avoid a Misdiagnosis

A recent post on ABC News about an alleged medical misadventure made many readers shudder.

It was the story of a Wall Street billionaire who claimed his doctors told him for a year he had meningitis that turned out to be cancer. Of course, the sooner you diagnose cancer, the better your chances of survival.

We’ve addressed misdiagnoses, and what to do if you think it’s happening to you.

The fear of misdiagnosis is real, and although patients often feel helpless in protecting against it-after all, aren’t medical professionals in the best position to determine what’s wrong?-patients can and should exercise oversight, whether they’re billionaires who can afford the best treatment, or people who barely can afford to pay attention.

One doctor quoted in the ABC story perfectly crystallized the situation: Health care, he said, “is provided by people, to people. So, without taking the human beings out of the system, you’re never going to get perfection.”

But pay attention you should, and writing on KevinMd.com, Evan Falchuk of Best Doctors, which advises companies about securing superior care for their workers, offers ways to reduce the chance of a misdiagnosis.

1. Know your family history and remind your doctor of it. Because family history is important in handicapping your chances of contracting certain diseases, learn your family’s medical history, and write it down (here’s a useful tool for doing so, provided by the Health and Human Services Department). Make sure your doctor knows about it-especially if you’re sick and they’re trying to decide what’s wrong.

2. Ask questions. A doctor might see 40 patients a day, spending only minutes with each. But asking questions won’t just make you feel more comfortable, it can disrupt your doctor’s thought process and make him or her think about your case in a new way that may save your life. Write your questions down in advance of your visit. Here, too, the HHS has advice about questions you should ask.

3. Don’t assume technology will save you. Technology is wonderful, but it’s not magic. “If I had to pick,” Falchuk writes, “between getting a high-tech test and a doctor who will spend an hour talking to me thinking about my case and putting all of the pieces together, the research says I should pick the doctor.”

4. Don’t always trust the tests. Readers of this blog will have heard this before. Tests can be wrong, they can signal less a diagnostic priority than a care provider’s insecurity, and they require judgment and experience to interpret.

5. Get a second opinion. A proper second opinion requires that the doctor look at your case from scratch-to hear you talk about your symptoms in your own words, and to assess your case without being influenced by the conclusions of your original doctor. Don’t offer the original doctor’s opinion; instead, describe your symptoms, explain your family history, the tests you’ve had done and help the doctor reach independent conclusions about what’s wrong with you.

We devoted an issue of our Better Health Care newsletter to the subject of getting to the right diagnosis. You can read it here.

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