February 23, 2006
Why Doctors So Often Get It Wrong
David Leonhardt in the New York Times:
With all the tools available to modern medicine — the blood tests and M.R.I.'s and endoscopes — you might think that misdiagnosis has become a rare thing. But you would be wrong. Studies of autopsies have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time. So millions of patients are being treated for the wrong disease.
As shocking as that is, the more astonishing fact may be that the rate has not really changed since the 1930's. "No improvement!" was how an article in the normally exclamation-free Journal of the American Medical Association summarized the situation.
This is the richest country in the world — one where one-seventh of the economy is devoted to health care — and yet misdiagnosis is killing thousands of Americans every year.
How can this be happening? And how is it not a source of national outrage?
A BIG part of the answer is that all of the other medical progress we have made has distracted us from the misdiagnosis crisis.
More here.
Posted by Abbas Raza at 11:21 PM | Permalink
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Comments
Another example of the typical drivel put out by the anti-medical-establishment groups. These are the same writers who complain about the rising costs of US healthcare, the inequities of access, and even the (gasp) long waits to see their physicians. They really seem to want to have their cake, and eat it too.
Comparing the diagnoses of myriads of diseases that afflict the human body with flying a commercial airliner is simply specious: no matter how complex the airliner, it was built by man, with every aspect of its construction, its parts and its operation documented and detailed. By contrast, a physician sees a patient with limited information and a very limited amount of time (no thanks to the health insurance system), and is then expected to deliver near-perfect diagnoses about just what is wrong. Should I add that they are also expected to do this while keeping the admittedly soaring healthcare costs under control?
Physicians and surgeons make mistakes because they are overworked, under-resourced, and have limited amounts of time with each patient. But even more importantly, mistakes occur because the myriad human diseases each have myriad presentations, many that are basically (overlapping) non-specific symptoms. Should physicians send every patient who comes in with a splitting headache off for a CT to rule out a brain tumor?
Computerized systems such as Isabel may assist physicians with differential diagnoses, but these systems are inherently *probablistic*. Never can a system, computer or human, say with absolute certainty that the diagnosis of a patient is such and such -- the process of diffrential diagnosis is inherently probablistic. Throw on the additional constraints of speed and low cost, and accuracy inherently gets worse.
Cheap, fast, accurate. Pick ONE, guys. Even then, don't expect 100% correct diagnoses.
Posted by: Anonymous | Feb 24, 2006 12:16:32 PM
"Physicians and surgeons make mistakes because they are overworked, under-resourced, and have limited amounts of time with each patient."
Are those the only possible explanations? Could errors also occur because physicians lack experience, don't have access to the latest information, and/or are arrogant? Indeed, it seems that few physicians are willing to admit the possibility that their diagnoses could be wrong. One interesting point made by the article is that considerable efforts are made to reduce pilot error -- and it makes perfect sense that similar efforts could be made in the field of medicine.
Posted by: Odysseus | Mar 2, 2006 6:09:22 AM
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