Medical misdiagnosis is a major contributor to unnecessary treatment, increased medical costs and poor outcomes for patients. Several recent studies published in Health Affairs show that many doctors do a poor job of “activating” their patients — engaging their patients, listening to their concerns, discussing treatment options and involving them in treatment decisions. Low activation rates lead to poor grades on a variety of healthcare quality measures, including cost, morbidity and mortality.
The Institute of Medicine recommends that physicians be trained to be better communicators in order to engage and involve patients. As a medical malpractice lawyer, I have to laugh at the silly euphemisms, such as “activation rates” and “patient engagement,” that researchers use in these studies to characterize this flaw in the healthcare system. Let’s face it, many doctors just don’t listen carefully to their patients.
Doctors are uniquely trained to use the differential method of diagnosis to arrive a patient’s diagnosis and treatment plan. A key part of the differential method is the history and exam during which the physician gathers important information about the patient’s current medications, past medical history, family history, risk factors and current symptoms. This is the birthing ground of much medical misdiagnosis. If the information obtained by the physician is the result of poor communication, cutting corners or jumping to conclusions, then the diagnosis is apt to be off.
The Institute of Medicine is beginning to recognize the need to change physician culture and convince doctors to accept a greater dialogue with patients. During an Institute of Medicine workshop addressing such issues, the following recommendations were made:
- Teach patients how to access and interpret their medical information
- Teach patients how to obtain medical care
- Present patients with options and listen to their concerns and feedback
- Establish a connection and relationship with patients
- Don’t use medical terminology when presenting information to patients
This is a long overdue start to an old problem. When doctors fail to listen to patients thereby failing to implement the differential diagnosis method properly, and a misdiagnosis occurs that results in harm to the patient, a claim for medical negligence or medical malpractice may exist under Ohio law.
