When something is wrong with us, we go to a doctor with the expectation that he or she will figure out what the problem is and what to do about it. But despite all the advancements in modern medicine, studies suggest, doctors make the wrong diagnosis in 10 percent to 15 percent of office visits for a new problem.
Errors occur, but it’s not necessarily because doctors aren’t smart or caring. Coming up with a medical diagnosis can be one of the most difficult tasks physicians perform, for a few reasons. They have to figure out what’s wrong with you when there’s limited time. (An average office visit lasts only about 21 minutes.) And the information you provide might be incomplete because you’re not providing an accurate history or you’re not able to articulate your symptoms.
It’s important to be involved in the process of diagnosing your condition, starting with when you make that first appointment. These steps can help:
● Make your appointment early. Try to schedule it earlier in the day so that your appointment is less likely to be shortened because your doctor is overbooked and is running late. And if you think you’ll need more time than usual or are going in to discuss a brand-new problem, say so when scheduling.
● Come prepared. Put a list of your health complaints together ahead of time, and prioritize them because time might be limited. Also, make note of the chronological order of symptoms related to each complaint. And bring a detailed medical history with a list of all the medications, including dietary supplements, that you are taking.
● Bring a buddy if possible. Whether going to your doctor’s office or to a hospital, ask a companion along to be your advocate, help you remember what transpires and get your doctor’s full attention. If you can’t bring someone, take notes so you have a record of what went on.
● Ask targeted questions. Help ensure that your doctor is thinking about your problem and giving it serious attention by asking key questions that encourage broad thinking. For example, if you come in complaining of fatigue and weight loss and the doctor says it sounds like a thyroid problem, ask, “Is there anything else it might be?” If the answer is no, then ask, “Why do you think that?”
● Insist on a diagnosis. A study led by Hardeep Singh, a patient-safety researcher at the Houston VA Center for Innovations in Quality, Effectiveness and Safety, found that primary-care providers failed to document a differential diagnosis — a list of possible diagnoses — in 81 percent of initial visits by their patients. If you go in with serious symptoms, such as shortness of breath, don’t hesitate to ask the doctor what might be causing them and how she plans to go about making a diagnosis, such as further tests or a referral to a specialist. Make sure you understand what the next steps are before leaving the office.
● Take charge of your test results. If you’re sent for more tests, particularly those related to heart disease or cancer, ask when you should expect the results. If you don’t receive them within that time frame, contact your doctor. “No news is not necessarily good news,” says Marvin M. Lipman, Consumer Reports’ chief medical adviser. You should read the details of all imaging and lab reports and ask your doctor for help interpreting them. Also ask how any abnormal results should be followed up, such as additional testing or even seeking a second opinion.
● Monitor your progress. If your doctor says that you should feel better under his treatment plan and you don’t, or you’re feeling worse or experiencing different symptoms, let him know. In Singh’s study, most of the harmful diagnostic errors were detected because patients were unexpectedly hospitalized or made a return visit to the doctor when their symptoms didn’t improve. He also found that mistakes from notes in patient’s files often contributed to errors. So ask to see your medical record to check on the accuracy and completeness of your doctor’s notes as well as your medical history and medication list. Compare them with your own notes and point out any errors.
● Get another opinion if needed. If you lack faith in your physician or if your condition isn’t resolved within a reasonable period, it makes sense to get another provider thinking about your case. Doctors are legally bound to cooperate with patients seeking a second opinion, including sending records, prescriptions, test results, letters and photographs to other physicians. If your doctor discourages you from seeking another opinion, consider it even more reason to get one.
For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.