You probably trust your doctor to diagnose and cure your symptoms. (It’s why you turn to her, not Dr. Google.) But even good doctors sometimes make mistakes—and it often happens right before your eyes: A recent study found that 80 percent of doctors’ diagnostic errors were made during the patient-doctor interaction.
Researchers from Baylor College of Medicine, Texas A&M, and University of Texas at Houston investigated the medical records of 190 patients at the Houston VA Health Services Research and Development Center of Excellence who ended up in the hospital or back at the doctor within two weeks of a primary care visit. Sixty-eight of the patients were diagnosed with previously-undetected health conditions as serious as cancer, heart disease, meningitis, dementia, iron deficiency anemia, asthma, and even HIV.
In 4 out of 5 of these cases, errors in the patient-practitioner encounter played a role in the missed diagnosis. For instance, doctors messed up diagnostic test orders and physical exams, and overlooked important parts of the patients’ medical records. And in 81 percent of cases, doctors skipped differential diagnosis, a routine but crucial part of the diagnostic process in which doctors reflect on their patient’s symptoms and exam, and record their thoughts on what the condition could be.
“It’s not that these doctors were negligible,” says lead study author Hardeep Singh, M.D., a research scientist at Baylor College of Medicine and chief of the Health Policy and Quality Program at the Houston VA Health Services Research and Development Center of Excellence. “It’s that the conditions that they’re treating are complex—even if they’re common.” Just think: Your pesky cough could be accompanied by any number of other symptoms. Plus, your aches and pains evolve over time: symptoms that scream bronchitis today could turn into pneumonia tomorrow.
And it doesn’t help that most doctors face the same work pressures as you. They, too, are pressed for time and pushed to be more productive—even though it’s your health that’s at stake.
While you can’t carve more time in your doctor’s day, you can help your physician help you with the best patient practices:
Bring a list of your symptoms
Doctors rely heavily on patient information, says Singh, so it’s important to present the most thorough picture of your health. If you’re on medication, feverish, or stressed, you might forget to mention the symptom that tips the scale toward the correct diagnosis. So make a list of your complaints before your exam, and whip it out when your doctor asks.
Answer questions thoroughly
During most medical exams, your doc should ask about your medications. The way she asks you is important–like, “Which medications do you take regularly?” or, “What meds have you taken today?”–but so is how you answer, says Singh. This is your time to take the mic and belt out a list of every pill you pop, from supplements to The Pill, and over-the-counter drugs. Even OTC cold medicines can quicken your heartbeat or disguise signs of sickness, says Singh.
Do your research
Spend too much time Googling your symptoms, and you’re bound to uncover a mild case of hypochondria (look it up!). But reliable, up-to-date resources like Medline Plus (not Wikipedia) can inform and empower you to ask smart questions (like, “Could I have strep?”). This creates a dialog that can ultimately help you and your doctor get to the root of your issue, together.
And if you have a preexisting health condition, or know of one that runs in your family? Stay abreast of its symptoms so you know what to look for. For instance, diabetics are prone to eye issues. If you have diabetes and haven’t had an eye exam in years, ask your doctor for an ophthalmologist referral.
Understand the plan
Before you leave the exam room, note your doctor’s answers to the following questions. Bring a pen and paper if it helps you remember.
• What do I have?
• What is the treatment and how long should it last?
• When should the treatment alleviate my symptoms?
• What should I do if I’m not feeling better then?
• What should I do if I feel worse?
• What’s the best way to reach you?
• Do I need any follow up tests, referrals, or visits?
Follow Doctor’s orders
If your doctor says to call or return if you’re not better in two days, do it, says Singh. And even if doctor doesn’t ask you to follow up, always call her if you’re not feeling better or feeling worse.
Be skeptical
“Doctors try their best, but we work in imperfect systems and are imperfect beings,” says Singh. “There’s a lot of uncertainty, and doctors make their best judgments. But mistakes happen.” If your doctor seems unsure about your diagnosis, it’s OK to return for a follow up visit or seek out a second opinion.
More from WH:
7 Signs of a Bad Doctor
13 Questions to Ask Your Doctor
Are You Honest With Your Doctor?
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