Medical Misdiagnosis: A Very Common Problem

When most people think of medical mistakes, medical malpractice or similar, they think of surgical errors (such as operating on the wrong patient or body organ,) or medication mishaps.

Hospitals spend billions of dollars collectively every year in quality control, quality assurance, and patient review systems.  Almost every hospital has what is known as a Committee on Mortality & Morbidity Review, to review and hopefully correct any patient errors that occurred under its roofs.  Entire organizations, such as the National Institute of Medicine, exist to improve patient care in large-scale hospital settings. 

What is far less watched and known, however, are the medical errors that occur at the much smaller, Primary Care Physician practice level and outpatient practice levels.  For it is here, at these ‘lower’ levels of practice, that critical diagnostic errors are so very common.  Late diagnoses, missed diagnoses and wrong diagnoses contribute to thousands of deaths every year in the United States- and far too little is done about it.  In fact, a recent study by the Institute of Medicine, which is s subdivision of the National Academy of Sciences, estimates that up to 12 million Americans each year may be the victim of various degrees and types of medical misdiagnosis.

Legally speaking, this type of case falls under the broad area of medical negligence, otherwise called medical malpractice.  However, these types of cases constitute a legal subspecialty practice area called “Failure to Diagnose.”  Such cases can involve a number of areas of medical practice.  More commonly, they tend to involve cancer misdiagnoses, cardiac related misdiagnoses, or as well as neurological misdiagnoses.  According to Victor Dzau, President of the Institute of Medicine, ‘‘Despite the pervasiveness of diagnostic error and the risk for patient harm, [primary and outpatient care misdiagnoses] have been largely unappreciated within the quality safety movement in health care and this cannot and must not continue.”  Ironically enough, the Institute’s groundbreaking 1999 report ‘‘To Err is Human’’ dramatically exposed the number of hospital deaths occurred each year due to hospital errors — as many as 100,000 a year — yet that report and a later one barely discussed diagnostic errors outside the hospital setting.

As a Massachusetts medical malpractice attorney who has seen many cases of medical misdiagnosis, I can assure my readers that this problem indeed exists, and that the causes are several.  Many medical and legal specialists have commented on these causes, including Paul Epner, Executive Vice president of the Society to Improve Diagnosis in Medicine, who  recently stated that “[Medical diagnosis] crosses so many different domains in the practice of medicine, which makes it complicated by itself.’’  As a Boston medical negligence attorney who has seen hundreds of these cases, I’d say that the above characterization is both true and not-so-true.  Diagnostic errors can result from a variety of causes, including poor collaboration and communication between clinicians, patients, and their families.  It can also be worsened by a health care culture that discourages honest disclosure of medical mistakes.  And sometimes, it’s just plain inattention to detail.  I’ve seen many of those cases, also.

Primary care and outpatient medical practices need to establish systems that identify diagnostic errors and the danger signs that accompany them.  Doctors need to be taught to speak up when they think they might have made a mistake – so they can learn from each other – before a serious injury or death occurs as a result of silence.

If you think you or someone you care about may have been the victim of medical misdiagnosis, it is important to make sure that the law firm you consult with, is extremely experienced in these cases, as they are very complex and required specialized expertise.

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