The central findings of research recently published in the medical journal JAMA Internal Medicine that focused on medical errors and misdiagnosis of illness conclude that misdiagnosis most frequently occurs very early in the doctor-patient encounter, often during an initial examination.
The study undercuts notions that new technologies such as electronic health records are panaceas that help to routinely identify illnesses and conditions, communicate them seamlessly through medical channels and prevent error.
As one media article noted in discussing the study: "[It] suggests that all of the fancy technologies available today are not an adequate substitute for a thorough diagnostic exam."
And that, apparently, is an uncommon -- even elusive -- event. Exams are often conducted in a rushed atmosphere, with patients not providing comprehensive information about their medical histories. Doctors often see a patient with an illness just once, without consistent follow-up. Physicians aren't always well trained in diagnosing and treating certain conditions. A problem often cited is that medical staffs don't routinely keep an adequate watch on diagnostic tests that are ordered.
As a result of those multiple and diverse factors, diagnostic errors "are a major, major public health problem," notes David Newman-Toker, a doctor at the Johns Hopkins University School of Medicine.
In fact, Toker says, at least 150,000 persons die or are seriously harmed each year from failed diagnoses.
The JAMA study cites researchers' findings on the conditions that are among the most commonly misdiagnosed. In descending order, those are pneumonia, heart failure, kidney failure, various cancers and urinary tract infections.
Source: Bloomberg, "Pneumonia, heart failure among most-missed diagnoses," Nicole Ostrow, Feb. 25, 2013
Physicians News Digest, "Medical mistakes common: breakdown in doctor, patient exams," Brad Broker, Feb. 25, 2013