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30 million Americans drew money out of retirement savings for emergencies last year, while 21 million didn’t save anything for retirement

Diagnosis often wrong or late, report says, and it calls for urgent changes

Most people will experience at least one diagnostic error – an inaccurate or delayed diagnosis – in their lifetime, sometimes with devastating consequences, according to a report from the Institute of Medicine of the National Academies of Sciences, Engineering, and Medicine.

Although getting the right diagnosis is key in health care, efforts to improve diagnosis and reduce diagnostic errors have been limited, the committee that conducted the study and wrote the report found.

Improving diagnosis is complicated, because it’s a collaborative and inexact process that can take place in different health care settings, the report said.

The report, and the video above, describes the experiences of a patient, Carolyn, who went to the emergency room because she was having chest pain and pain down her left arm. She’d heard that pain in the left arm could be the symptoms of a heart attack. She had tests, but they were negative. The doctor told she was in the age group for acid reflux. Carolyn asked a lot of questions and a nurse complained to her, because she said the doctor didn’t like to be questioned. She was sent home.

Carolyn continued to feel poorly, but didn’t want to return to the emergency room because she might be seen as a difficult patient.

Two weeks later when she went back to the emergency room, she had to have a procedure for a 95 percent blocked artery. She was having a heart attack and said her recovery would have been better if she had received the correct diagnosis earlier. Carolyn continues to have cardiac problems, and she had to quit her job.

To improve diagnosis and reduce errors, the committee called for:

  • More effective teamwork among health care professionals, patients, and families.
  • Enhanced training for health care professionals.
  • More emphasis on identifying and learning from diagnostic errors and near misses in clinical practice.
  • A payment and care delivery environment that supports the diagnostic process.
  • A dedicated focus on new research.

The report is part of the institute’s Quality Chasm Series, which includes reports such as “To Err Is Human: Building a Safer Health System,” “Crossing the Quality Chasm: A New Health System for the 21st Century,” and “Preventing Medication Errors.”

Victor J. Dzau, president of the institute, said the studies have resulted in improvements in patient safety and quality care.

“But this latest report is a serious wake-up call that we still have a long way to go,” Dzau said. “Diagnostic errors are a significant contributor to patient harm that has received far too little attention until now.”

He said the report on diagnostic errors will have a profound effect on the way the health care system operates and the lives of patients.

Patients also have a role to play in accurate diagnoses. To communicate effectively with your doctor, here are 10 questions you can ask from the Agency for Healthcare Research and Quality:

  1. What is the test for?
  2. How many times have you done this procedure?
  3. When will I get the results?
  4. Why do I need this treatment?
  5. Are there any alternatives?
  6. What are the possible complications?
  7. Which hospital is best for my needs?
  8. How do you spell the name of that drug?
  9. Are there any side effects?
  10. Will this medicine interact with medicines that I'm already taking?

Visit Questions to Ask Your Doctor on the agency website for additional checklists.

See also the Consumer Reports article, “How to Talk to Your Doctor,” for additional tips on what to do when you visit your doctor including accurately reporting your symptoms and how long you’d had them.

Copyright 2015, Rita R. Robison, Consumer Specialist

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