When Missing a 'Zebra' Can Land You in Court

Mark Crane


February 20, 2018

In This Article

Doctors May Think They Have It Right

No one is exactly sure how often physicians misdiagnose or are late to diagnose medical conditions. "In most diagnostic errors, the physician was pretty sure of what was going on, except it turned out to be something else," said Mark Graber, MD, founder of the Society to Improve Diagnosis in Medicine.

"Most doctors don't even think about their track record in making diagnoses," he said. "Autopsies have virtually disappeared. Doctors don't get high-quality feedback. Often, you'll never even hear if you injure a patient, who may go see someone else after you. Few healthcare organizations are measuring the incidence of diagnostic error in their own practices."

A 2014 Institute of Medicine study[2] estimated that 5% of US adults, or 12 million patients a year, are misdiagnosed. Many of the errors are inconsequential, but some lead to serious complications and death.

It takes an average of 7.6 years for a US patient with a rare disease to receive the proper diagnosis, the 2013 Shire Disease Impact Report found.[3] Such patients typically visit up to eight physicians before they get the right diagnosis. Shire is an Ireland-based global specialty pharmaceutical firm.

Listen to the Patient and Family

About half of physicians Shire surveyed said that professional medical organizations don't give enough attention to rare diseases. More than half said that there aren't enough opportunities to network with other physicians who treat rare diseases. Primary care physicians "may miss the indications of a rare disease because they may have never seen a particular rare disease before, or the disease presents the signs and symptoms of a more common disease," the report found.

The biggest mistake physicians make is not listening to the patient or his family when they say something is wrong, said the experts we asked.

"When the family tells you something isn't right, listen carefully," said Dr Kanich. "If a parent tells me their child isn't well, I tend to believe them. Nobody knows their child better than the parents."

Dr Graber agrees. In the cases he's studied, parents "kept insisting that something was wrong and that the assigned diagnoses didn't seem correct. We hear this over and over from patients that they weren't listened to."


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