20 percent of patients with serious conditions are first misdiagnosed, study says

[simple girl]

"More than 20 percent of patients who sought a second opinion at one of the nation’s premier medical institutions had been misdiagnosed by their primary care providers, according to new research published Tuesday."

https://www.washingtonpost.com/national/health-science/20-percent-of-patients-with-serious-conditions-are-first-misdiagnosed-study-says/2017/04/03/e386982a-189f-11e7-9887-1a5314b56a08_story.html?utm_term=.70af5366e40b

Happened to me not once, but twice! I almost always get a second opinion for potentially serious matters now.

Take heart, though:

"With or without the help of their initial provider, those people sought additional advice from the Mayo Clinic’s internal medicine department. That makes the group somewhat different from the general population, Naessens said, because their conditions were serious enough to merit another look by some of the best physicians in the country.

“It’s not going to be 20 percent wrong every time” a patient goes to see a doctor, Naessens said."

 

[H2ODude]

Very good friend had a bout of prostatitis. Always had had a somewhat elevated PSA test, but it went through the roof with that. Dr. watched it come down to some level I don't know, but then highly recommended a biopsy. He was very aware of the possible side effects (infection) so went for second opinion...at Mayo. There they said wait 6 months monitoring PSA each month. Hopes to avoid any of it. Makes me a strong believer in second opinions. He may still end up with the knife, but no need to rush.

 

[RAE]

20% actually sounds low to me. Based on my experience (and DW's), it's not at all uncommon (for non-simple issues) to be misdiagnosed by one, if not several, docs before finding one who even comes close to figuring out what the source of the problem is. I attribute this mainly to the way medicine is practiced by many doctors (at least when dealing with somewhat complex, chronic disease issues)......they want to treat individual symptoms (usually with a drug, or another test), but are not good at tying all of your symptoms together to get at the source of the problem. Treating individual symptoms may mask the problem for a while, but it doesn't do much to fix it. If you can find a good functional medicine doc (which is not at all easy), you are very fortunate.

 

[Car-Guy]

Very good friend had a bout of prostatitis. Always had had a somewhat elevated PSA test, but it went through the roof with that. Dr. watched it come down to some level I don't know, but then highly recommended a biopsy. He was very aware of the possible side effects (infection) so went for second opinion...at Mayo. There they said wait 6 months monitoring PSA each month. Hopes to avoid any of it. Makes me a strong believer in second opinions. He may still end up with the knife, but no need to rush.

I've known a couple of older men that had high PSA's (over 10 they said) for years and no cancers detected after more "invasive" testing was done. After hearing about some of the more invasive testing procedures and resulting problems, I'm not so sure I'd have the test done, especially with so many false positives. (False positive = high PSA but non cancerous)

 

[Meadbh]

Given that most illnesses present with one or more common symptoms, the differential diagnosis (aka list of possible causes) is usually very long. Physicians are trained to evaluate the possibilities based on probability (how frequent the cause is in the general population and in people like the patient). Heuristic thinking is common, as is confirmation bias. Common diseases are common. Rare diseases usually have no pathognomonic (unique) symptoms are often diagnosed after eliminating more common diseases, often when treatment for the more likely disease fails to work. It's called decision making under uncertainty.

 

[Car-Guy]

"More than 20 percent of patients who sought a second opinion at one of the nation’s premier medical institutions had been misdiagnosed by their primary care providers, according to new research published Tuesday."

I guess this is why they say a doctor is "practicing medicine".