Outrageous cases of medical malpractice — an operating surgeon leaving a surgical instrument inside a patient’s body or amputating the wrong limb — naturally receive a lot of attention when they are exposed. But the most common type of medical malpractice, misdiagnosis, is not as well-known, and it can be just as deadly.
The term “misdiagnosis” includes diagnoses that are incorrect, delayed or overlooked, and it is believed to play a role in 10 to 20 percent of all medical cases. That makes misdiagnosis much more common than drug errors or operating on the wrong patient.
A 2012 meta-analysis published in BMJ Quality & Safety found that there were 40,500 fatal diagnostic errors per year in intensive care units in the United States, which is equal to the annual number of deaths caused by breast cancer.
Misdiagnosis is not only a problem with rare diseases. A study of medical errors in a Texas VA hospital system found that many errors involved common diseases like urinary tract infections and pneumonia. The study estimated that there are a minimum of 500,000 missed instances of misdiagnosis out of 500 million annual primary care visits in the United States.
Diagnostic errors happen more often in primary-care settings, and studies have found that they typically involve not only negligence, but flawed ways of thinking about medical issues. Still, medical professionals’ negligence is a large part of the problem. A 1991 Harvard University study found that 75 percent of medical errors involved negligence.
Compounding the problem is the fact that misdiagnosis is believed to be severely underreported. Cases that result in medical malpractice lawsuits or shocking headlines only represent a tiny fraction of the dangerous mistakes that are made every day in hospitals and doctors’ offices across the country. Medical professionals are not motivated to reveal their own mistakes or those of their colleagues, and reporting requirements are lax or nonexistent. Mark L. Graber, a leading researcher of medical errors, has said that he does not know of a single hospital in the United States that tracks diagnostic mistakes.
The lack of data means that change within the health care industry will be slow in coming. In the meantime, patients need to protect themselves.
Become your own health care advocate. Keep a close eye on your medical records and ask questions, especially when a diagnosis changes or something about your treatment seems unusual.