Wednesday, April 19, 2017 by Amy Goodrich
When you are sick, it is not always easy to find the right path forward. When your regular health care provider recommends surgery or a major treatment, it might be a good idea to get a second opinion after the Mayo Clinic reported that your doctor is wrong 88 percent of the time.
Even though the path to becoming a physician is long, with four years of college to get a bachelor’s degree, another four years of medical school, and three to seven more years of residency and fellowship training, experienced and well-trained doctors may still not get your diagnosis right. A second opinion may give you not only peace of mind, but also a second chance at survival.
The Mayo Clinic researchers examined 286 patient records of individuals who had decided to consult the Mayo Clinic’s General Internal Medicine Division in Rochester for a second opinion between 2009 and 2010. The group consisted of patients referred by nurse practitioners and physician assistants, along with an equal number of randomly selected physician referrals.
To determine the extent of diagnostic errors, the team compared the referring diagnosis to the final diagnosis. The researchers found that only 12 percent of patients received a correct first diagnosis, while nearly nine out of ten people (or 88 percent) who go for a second opinion, walk away with a refined or entirely new diagnosis from what they were first told. In 21 percent of all analyzed cases, the diagnosis was completely different than the first one, while 66 percent of patients walked away with a redefined diagnosis.
“Effective and efficient treatment depends on the right diagnosis. Knowing that more than 1 out of every 5 referral patients may be completely [and] incorrectly diagnosed is troubling — not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all,” said lead researcher James Naessens, Sc.D., a health care policy researcher at Mayo Clinic, in a statement.
According to a controversial study from Johns Hopkins University, medical errors, including misdiagnosis, are the third-leading cause of death in American hospitals. ProPublica, however, noted that this number might be higher since doctors don’t list medical errors on the death certificate, so the actual number of fatalities might be inaccurate.
With thousands of diseases, some with similar symptoms, it is not always easy to get a straightforward diagnosis from the first doctor’s visit, hence why a second opinion is so crucial to one’s health and survival. If we can learn anything from the Mayo Clinic’s study, then it is the fact that medical practices and diagnosis should be a more collaborative process. Doctors and other health care providers should work more closely together to make sure patients get the right diagnosis and proper treatment as fast as possible.
Despite the pervasiveness of diagnostic errors, which could be fatal, little attention has been given to improving the system of referrals. Dr. Naessens stated that referrals to advanced specialty care for undifferentiated problems are an essential component of patient care. While getting a second opinion might push the diagnostic costs up, a misdiagnosis could lead to delays in treatments and complications, which may result in the death of a patient.
Dr. Naessens, however, is pleased to see that the National Academy of Medicine is taking steps to improve diagnostic processes and error reduction. They called for dedicated federal funding and plan to further investigate the occurrence of diagnostic mistakes and find new ways to improve the process.
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