In October 2015, a jury awarded $2.2 million to a Pennsylvania man in a medical malpractice case. During the trial, a surgeon testified that had the plaintiff’s spinal fracture been properly diagnosed the man would be able to walk. Instead, the fracture was overlooked, and the injury caused permanent paralysis.
That case is an extreme example of diagnostic error – when medical personnel miss signs of an illness or injury or incorrectly assign a diagnosis. And those mistakes are the leading cause of medical malpractice lawsuits, according to the Patient Safety Authority of Pennsylvania.
The Authority reports that from January 2005 through August 2009, the most commonly misdiagnosed conditions were metastatic cancer, fractures, pulmonary embolism, acute coronary syndrome, and appendicitis. Often, the reason for misdiagnoses is that a physician fails to order appropriate medical tests that would reveal the true cause of a patient’s ailment, and many diagnostic errors occur not in a hospital setting, but when patients visit their primary care physician.
A study of malpractice suits involving Massachusetts primary care physicians found 72 percent of the 550 cases alleged claims of misdiagnoses. Malpractice insurers settled 35 percent of those cases, most of which revealed a missed cancer diagnosis.
To arrive at a diagnosis, a physician relies on a patient’s medical history, the patient’s description of symptoms, results of a physical examination, and, if necessary, the results of additional medical tests. But when primary care doctors are spending only 15 minutes with patients, they may overlook important symptoms.
In 2014, Reid Blackwelder, the president of the American Academy of Family Physicians, told USA Today that a fee-for-service payment model pressures doctors into seeing more patients per hour in order to cover overhead, staff salaries, and other costs. That means many doctors are seeing patients in back-to-back 15-minute intervals, and some physicians who work for hospitals have been asked to see a patient every 11 minutes.
When doctors are rushed, they may develop a theory about a diagnosis before collecting all the information they need. One study of 29 family medical practitioners found that doctors let patients speak about 23 seconds before doctors redirected them. A University of South Carolina study found that primary care patients spoke an average of 12 seconds before being interrupted – by a beeper, computer use, a knock on the door, or by the doctor. In the average visit of 11 minutes, patients spoke about four minutes, and doctors frequently interrupted patients before they finished speaking.
Doctors cannot adequately rely on their diagnostic abilities if they don’t let patients describe what’s wrong. Furthermore, when doctors are distracted, they may not be fully attentive to what patients are telling them.
The Patient’s Role
Doctors follow algorithms in making a diagnosis and determining a course of treatment. That means that when a patient uses certain words or describes certain symptoms, a doctor begins matching those factors to known conditions. So if a family member has the flu, and you report feeling rundown and have a fever, a doctor may immediately decide you should be treated for the flu, even though fever and lethargy could be symptoms of another condition.
The book “When Doctors Don’t Listen,” written by two emergency room physicians, promotes the concept of patient-focused care and points out the inherent problems of algorithmic medicine. The authors provide guidance about how patients can use context, chronology, and even drawings to help doctors understand their symptoms.
Our Philadelphia Malpractice Lawyers
If you have any questions about this topic or believe that a misdiagnosis is responsible for your injury or illness, our attorneys can help. For almost 40 years, we have been the trusted advocates for countless personal injury victims and their families throughout Pennsylvania and New Jersey. We encourage you to contact us today by calling 800-969-4400 or filling out a free case evaluation form.