Misdiagnosis a Common and Underreported Problem

All people make mistakes and doctors are no exception to this rule. While most doctors get it right, a startling number of errors that providers make are preventable and often result in overconfidence on the physician's part.

The story of McKenzie Fredrick illustrates the disturbing consequences that can occur when doctor's get it wrong. Born in December of 2007, McKenzie's troubles began almost immediately. She had trouble feeding and even sleeping was difficult for her. Doctors put McKenzie through a myriad of tests, eventually removing a portion of her thigh muscle to test for mitochondrial disorder. Doctors expected her to die before she reached the age of two.

McKenzie and her family relocated to New York and prepared for her death. Her parents contacted new doctors searching for answers. Eventually, a different doctor performed another muscle biopsy and determined that she did not have the mitochondrial disorder.

McKenzie recently celebrated her second birthday, is eating on her own and is living a normal childhood. Unfortunately, she will deal with the physical effects of the misdiagnosis for the rest of her life.

Due to the nature of misdiagnosis errors, it is difficult to determine how often they occur. Only the serious errors are reported or have claims made against them and many minor, inconsequential errors go unreported.

According to Dr. Elizabeth Burton, a medical scholar and director of autopsy pathology at Baylor University Medical Center, experts find a 40 percent diagnostic error rate in cases where an autopsy was performed. In over 10 percent of those cases, the error was significant enough that if the diagnosis had been correct or caught in time, the patient would have survived.

This is consistent with a 2008 report in The American Journal of Medicine which found diagnostic errors of 10 to 15 percent in many fields. Errors in specialty fields such as pathology, radiology and dermatology were fewer, at less than 5 percent. The report also indicated that overconfidence of the physician and lack of feedback after a diagnosis are also a problem.

Patients can play a role in helping avoid incorrect diagnoses by engaging in better communication with their doctors. Many patients feel more comfortable listening to the doctors than questioning them. But, Dr. Mark Graber, of the State University of New York at Stony Brook and VA Medical Center in Northport, N.Y., says this is the wrong approach. One of the best ways for a patient to protect him or herself is to ask the doctor what their condition might be or what other diagnoses the doctor is considering.

Questioning the provider throughout the process, as well as keeping track of a patient's own medication lists, test results and medical information can all help reduce errors in the system.

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