Patient Advocacy and Misdiagnosis Prevention

Diagnostic errors account for an estimated 40,000-80,000 deaths in the U.S. each year. In this blog post, we will discuss what it means to be misdiagnosed, the primary causes of misdiagnosis, the significance of listening to patient complaints, and the ways through which misdiagnosis cases can be legally pursued.

Leading Reasons For Misdiagnosis

Some of the most common reasons for misdiagnosis involve human factors, like cognitive bias, communication breakdowns, and inadequate follow-up. For example, it’s common for physicians to rely heavily on the first piece of medical information that’s provided. However, whether an inaccurate history was taken down by paramedics or the triage team failed to recognize the severity of symptoms, medical professionals must constantly assess and reassess their patients, consider all possible diagnoses, and take action to rule out conditions that are not medically supported or confirmed.   

Patients Become Powerless

Patients have historically been at a disadvantage when it comes to relaying symptoms to medical professionals. Because they are not feeling well, patients often feel powerless and afraid. Even doctors and nurses feel vulnerable when they become patients. It’s harder than ever for patients to speak up because today’s healthcare system is set up to diagnose, treat, and move on to the next patient. The time constraints placed on doctors and nurses to see as many patients as possible in an often chaotic hospital environment only increases the potential for diagnostic mistakes. Doctors often feel rushed, leading to incomplete assessments.

Bias and Prejudice in Healthcare

Often times, healthcare professionals carry biases that affect their ability to 

exercise the expected degree of clinical judgment. It’s well documented that factors like race, ethnicity, age, social status, and obesity play a significant role in prejudging patients resulting in ill-informed opinions that can have devastating consequences. But, there is also a bias against younger patients without significant medical histories who present with nonspecific complaints. Because younger patients often appear vibrant, their complaints are often dismissed as exaggerated, attention seeking, or somatic in nature. In fact, it’s common for medical staff to downplay symptoms in otherwise healthy patients, especially young and vibrant people who do not suffer from an underlying chronic disease or condition. 

Failure to follow up on abnormal test results or symptoms. Misinterpreting or over-relying on diagnostic tests instead of. Healthcare providers may lack experience with rare or complex conditions. Errors or missing information in electronic health records can lead to incorrect diagnoses

The Importance of Believing Patients

Each patient begins with a screening process by both nurses and physicians to determine the understanding of the case. However, many patients are unable to describe their condition and the symptoms. This could perhaps be a vague uneasiness or a sense that something is not right, yet they are not coughing or sneezing, and such issues are easily brushed aside.

Healthcare professionals must appreciate that when a patient reports feeling sick, even if their chief complaint is that, “something just doesn’t feel right.” Listening to such complaints and assigning value to them is very important, and every physician and nurse should be trained to do so. 

Institutional Barriers 

Logistical and administrative factors are another cause of misdiagnosis in the health care system. Another important concern is that sometimes important laboratory tests are not ordered on time because the doctor is unsure of the severity of the patient’s symptoms. This delay may result from concern or uncertainty regarding a particular hospital's reimbursement policies. As for hospital inpatient care, healthcare providers are very cautious about admitting patients because sometimes insurance companies will not pay if the procedure is deemed unnecessary. This can be a dangerous approach that delays diagnostic and therapeutic procedures when necessary.

The Influence of Corporate Medicine

Most hospitals today, especially those owned by companies, are in business to make profits. This profit-oriented approach tends to lead to the employment of less skilled manpower, like family practitioners, in EM as opposed to contracted EM physicians. Perhaps this is a way of trying to contain costs, but it can lead to diminished quality of care for the patient.

Emergency rooms, in many cases, are not actually located within the hospitals where they are situated. This actually is a disadvantage since it creates a disconnect in the patient’s treatment process. Every time a patient is admitted, the patient goes through another set of interviews, which we can describe as a second intake. Nevertheless, if this step is deferred, then it would lead to a delayed diagnosis and, consequently, delayed treatment.

Additionally, hospitals are known to have staff shortages, and this has been cited as the cause as well. ERs filled with patients while staffing remains low need to be more capable of providing adequate triage and care, which may lead to giving limited attention to patients. When the emergency rooms are congested, the capacity to take in other patients reduces, and the likelihood of inaccurate diagnosis increases as well.

Supporting Patients With Professional Healthcare Advocacy 

Independent Patient Advocates play an indispensable role in the healthcare system, especially in managing severe conditions like bacterial meningitis. By ensuring timely diagnosis, facilitating rapid treatment, and providing emotional and practical support, they enhance patient outcomes and improve the overall quality of care. For patients and their loved ones facing the terrifying prospect of a misdiagnosis, having an Independent Patient Advocate can mean the difference between life and death, offering a lifeline in the midst of medical uncertainty.