Why People and Pets May be Misdiagnosed
Failure to Diagnose
Many people may be under the impression that physicians are always right. After all, how many times have you heard the statement “Well, I was feeling ill and visited my doctor but I was told that everything is “normal” so I must be just fine. How can you determine whether in your situation things are truly fine or if you may need to seek a second opinion?
Understanding the realities and limitations of what modern medicine can do is a good first step. Although you’d like for your doctor to have a crystal ball and always have the correct answer, just knowing that physicians are taught to diagnose illnesses based on a patient’s symptoms along with some statistics can be helpful for patients who may question if there is something going on that their doctor may have missed.
How do statistics come into play you may ask? Well, when physicians or health care professionals are trained, they are taught to analyze data in order to formulate a diagnosis in terms of how likely it is for a patient to have a certain condition.
To further explain, let’s say that you are short of breath and seek medical attention. There are many conditions that can cause you to have shortness of breath. Being out of shape or sedentary is one such type of condition.
However, there are also medical problems such as asthma, coronary artery disease, COPD, and anemia that can also cause dyspnea or shortness of breath.
If a patient is overweight or has not been exercising regularly, there is a potential that they could be misdiagnosed as being only “deconditioned” and no further testing will be performed. This can be dangerous or even life threatening if the patient has other illnesses that are not properly evaluated.
The truth of the matter is that the medical system has caused harm to a great many patients.
In 2000 physician and health services researcher, Barbara Starfield, M.D. M.P.H analyzed several studies and found that in the 10 year period prior there were 225,000 Americans who lost their lives due to medical treatments.
Physicians Were 3rd Leading Cause of Death in US Study – Killing 225,000 People
Barbara Starfield, M.D. (2000)
That’s a staggering number. When you break down those numbers a bit further, that means that 225,000 Americans lost their lives from the medical system and physicians they entrusted with their health.
They died from their medical care. Hospitals and doctors caused more deaths each year than from pneumonia, diabetes, chronic respiratory illnesses, cerebrovascular accidents, and Alzheimer’s disease.
Dr. Starfield, a Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of health, devoted her life towards research identifying important issues for patient care. Two of her books in the primary care arena: Policy and Primary Care: Balancing Health Needs, Services, and Technology, and Primary Care: Concept, Evaluation, and Policy, brought to light some of the more challenging issues facing patients and their providers.
Starfield also published “Reinventing Primary Care: Lessons From Canada For the United States,” in the Health Affairs May 2010 issue.
In that article Starfield said,
“Differences in health—both overall and regarding social disparities—in two countries that are otherwise quite similar [Canada and the United States] are attributed to the important effect of two related phenomena: achievement of important health-system characteristics and a strong clinical primary care infrastructure in Canada. Several international studies have confirmed the importance of three health-system characteristics of countries that achieve better health at lower cost: government attempts to distribute resources, such as personnel and facilities, equitably; universal financial coverage either through a single payer or regulated by the government; and low or no cost sharing for primary care services.”
Dr. Starfield passed away June 10, 2011 at the age of 78.
Differential Diagnosis and Failure to Diagnose
In both human and veterinary medicine, doctors in training are reminded frequently about a principle called Occam’s Razor, which basically means that to think in terms of the simplest explanation for a problem. A common example often used in medical education is the concept that if you hear hoof beats, the most likely explanation would be horses, not zebras.
The problem with always using this theory is that along the way, we may have educated our doctors right out of being able to think outside the box. If each doctor you are seeing has their own preconceived idea about what is wrong, then this can lead to not one but multiple misdiagnoses.
And that, when you as a patient, don’t understand that your doctor is making an “educated” guess about your condition, you may take their word as absolute, even if you have ongoing problems which do not resolve. Doctors, like everyone else, are only humans, and as such make mistakes.
And humans are not the only ones being affected by this issue. In veterinary medicine as well, pet owners as well may find that even with follow up visits to a veterinarian, pets can be misdiagnosed.
Medical Errors With Pets
A pet owner in Texas reported that their beloved dog, an important, integral member of the family had seen more than six different veterinarians in a one year period, and although they were asking for numerous second opinions and explaining their pets symptoms very succinctly and descriptively, not one of the six doctors was able to correctly diagnose the dog.
Because in Texas where the pet resided, for the past several years allergy symptoms were quite pervasive in both pets and animals. Therefore, each time the owners took the dog into to see a veterinarian, they were told that the symptoms the dog was experiencing were nothing more than common allergies.
In fact, one of the specialty veterinary hospitals which had internists (which have more training than a regular veterinarian) and a dermatologist on staff, where the owners took their dog twice for consultation because the dog’s symptoms were not improving, actually wrote in the dog’s chart that the owner was counseled not to use the services of the specialty veterinary hospital for “routine skin issues”.
A few months after the second visit to the veterinary specialty hospital, the dog was diagnosed with Epitheliotrophic Lymphoma. The diagnosis was made because finally, a biopsy was done on the skin lesions. Prior to getting the diagnosis, not one of the doctors had taken the time to even consider doing a biopsy. In this case, the dog had a type of Lymphoma that attacks the skin. The dog had been misdiagnosed with allergies by at least six different veterinarians because each one was “looking for horses” and no one considered zebras.
How to Protect Yourself From Being Misdiagnosed
Getting the correct diagnosis can sometimes be a long and frustrating road. If you, a family member, or a cherished pet has symptoms that are not alleviated by the treatments you are given, or if your “gut feeling” says that your doctor is wrong, please seek out additional medical care and second, third, or even more opinions if you need to do so. In some upcoming articles we’ll be discussing some of the ways you can speak to your doctor to encourage them to “think outside of the box” and will also give you other tips on how you can avoid being misdiagnosed.
Until next time, may you all be in Good Health!
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