Systemic Issues and Continuity of Care
Barriers to Addressing Misdiagnosis
Reducing Misdiagnosis: Solutions
Introduction
Each year, around 800,000 Americans either die or have permanent disabilities due to medical misdiagnosis (Newman-Toker et al., 2023). Misdiagnosis, whether it’s a delayed, incorrect, or missed medical conclusion, can have devastating consequences. Though the chance of an error in any single doctor’s visit may seem low, the large number of patients seen annually leads to a serious nationwide concern (Newman-Toker et al., 2023). This widespread problem results not only in physical harm but also in emotional trauma and financial hardship, demonstrating that misdiagnosis is one of the most pressing challenges in medicine today.
Impact of Misdiagnosis
Approximately 371,000 deaths and 424,000 cases of permanent disability are linked to misdiagnosis each year in the United States alone (Newman-Toker et al., 2023). In many cases, misdiagnosis may take a profound emotional toll on families when their loved ones are harmed by incorrect diagnoses. In some cases, the loss is irreplaceable, leading to grief, mistrust in healthcare providers, and psychological distress. Financially, the cost of treating complications from missed diagnoses, especially for conditions like strokes or cancer, can quickly add tens of thousands of dollars to a patient’s medical bills (Sittig & Singh, 2015).
High-Risk Conditions
In the case of misdiagnosis, nearly 40% of all serious harm results from diagnostic errors of stroke, sepsis, pneumonia, venous thromboembolism, and lung cancer (Newman-Toker et al., 2023). It is important to note that these are all high-risk conditions where early detection is crucial. Failure to promptly diagnose these conditions can result in hindered and/or incorrect treatments leading to possible long-term disability or fatalities (Newman-Toker et al., 2023).
Misdiagnosis in Dermatology
Misdiagnosis is also very prevalent in dermatology, where visual assessments can be misleading. In Episode 10 of The Blissy Experience podcast, Dr. Pooya Beigi, a dermatologist and founder of the Misdiagnosis Association and Research Institute (MARI), highlights how skin conditions like eczema, hives, and even skin cancer are frequently misidentified. He notes that patients often attempt self-treatment with over-the-counter remedies, which may provide temporary symptom relief but can obscure underlying conditions, which can postpone accurate diagnosis and timely intervention (Blissy, 2024).
Causes of Misdiagnosis
The reasons behind misdiagnoses are complex, involving both human and systemic issues. One of the most common causes is simply miscommunication (Tiwary.,2019). Patients may not always accurately recall or explain their symptoms, and doctors may misinterpret the information provided or fail to ask the right follow-up questions (Singh et al., 2013).
Systemic Issues and Continuity of Care
On the systemic side, the way healthcare is delivered today also contributes to the issue of misdiagnosis. Since patients often see multiple specialists, it’s easy for important pieces of information to be lost between appointments and providers. One doctor might not know what another has already tested or observed, and that lack of continuity can delay or derail the path to an accurate diagnosis (Haggerty et al., 2019). Overall, fragmentation of care can result in an incorrect understanding of the patient’s overall health, increasing the risk of misdiagnosis (Haggerty et al., 2019).
Barriers to Addressing Misdiagnosis
Addressing misdiagnosis is also complicated due to many factors. One of the most prominent is the fact that many patients may never know they were misdiagnosed, especially in cases where the condition was minor or eventually resolved on its own. This makes it hard to identify patterns or learn from past mistakes. Additionally, legal, and ethical implications also make this a difficult problem to solve (Gallagher et al., 2007). While some misdiagnoses lead to malpractice lawsuits, these cases are typically challenging to prove. Many factors contribute to a misdiagnosis and differentiating between understandable human error and negligence is not always straightforward (Gallagher et al., 2007). Fear of legal consequences can discourage open discussions about misdiagnosis, which limits opportunities for learning and systemic change. Another major obstacle is the lack of national data. Unlike other medical errors, diagnostic mistakes are not tracked across institutions, leading to no reliable national statistics. Due to this, healthcare systems may underestimate the scale of the problem and not properly address the tools and training needed to fix it (Newman-Toker et al., 2023).
Reducing Misdiagnosis: Solutions
Despite these challenges, there are steps that can be taken to reduce misdiagnosis in medicine. One of the most important ways is by improving communication and collaboration across the healthcare system. Interdisciplinary case reviews, shared electronic health records, and better procedures to transfer patient information between institutions can all help ensure that critical information isn’t lost between providers (Robertson et al., 2022). Technology can also be a part of the solution. Artificial intelligence and machine learning tools are being developed to help flag early signs of conditions that are often misdiagnosed. These systems can be used as a backup system, helping providers consider overlooked possibilities (Robertson et al., 2022).
Conclusion
Overall, misdiagnosis in medicine is a widespread and dangerous issue caused by both human error and systemic problems. Each year, hundreds of thousands of people are either left permanently disabled or die as a result of diagnostic mistakes, and the consequences reach far beyond physical health, ranging from emotional trauma, financial hardship, and loss of trust in the healthcare system. While the individual risk may seem small, the overall impact is immense, and the need for reform is clear. By investing in better education, stronger collaboration, and advanced technology, the medical community can move toward a future where misdiagnosis is far less common.
References
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https://www.youtube.com/watch?v=yA7PpiNM600
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Haggerty, J. L., Roberge, D., Freeman, G. K., & Beaulieu, C. (2013). Experienced continuity of care when patients see multiple clinicians: a qualitative metasummary. Annals of family medicine, 11(3), 262–271.
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Newman-Toker, D. E., Wang, Z., Zhu, Y., Nassery, N., Saber Tehrani, A. S., Schaffer, A. C., & Makary, M. A. (2023). Burden of serious harms from diagnostic error in the USA. BMJ Quality & Safety, 32(5), 285–296.
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Singh, H., Giardina, T. D., Meyer, A. N. D., Forjuoh, S. N., Reis, M. D., & Thomas, E. J. (2013). Types and origins of diagnostic errors in primary care settings. JAMA Internal Medicine, 173(6), 418–425.
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Sittig, D. F., & Singh, H. (2015). A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. Quality & Safety in Health Care, 19(Suppl 3), i68–i74.
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Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by health care professionals may lead to life-threatening complications: examples from two case reports. Wellcome open research, 4, 7.
https://doi.org/10.12688/wellcomeopenres.15042.1
Provided and edited by the members of MARI Research, Error in Medicine Foundation, and MISMEDICINE Research Institute, including Kisha Patel, Bukky Alausa, and Dr. Pooya Beigi, MD. MSc.
