Drummond is among the untold number of Americans affected by a medical diagnostic error each year. Exactly how many are difficult to determine
"There is no single health care organization in the country that measures their diagnostic performance," said Dr. Mark Graber, chief medical officer of the Society to Improve Diagnosis in Medicine.
A 2014 study published in the medical journal BMJ Quality & Safety found at least one in 20 U.S. adults will experience a diagnosis error every year. Many of these errors are trivial, Graber said, though an estimated 40,000 to 80,000 deaths are linked to a diagnosis error annually. Beyond the consequences for a patient's health, and misdiagnosis can also mean waste money on unnecessary tests and treatments
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Doctors, with the help of modern tests, make the correct diagnosis in the vast majority of cases, but Graber said there is room do better. The Society to Improve Diagnosis in Medicine was formed in 2011 to support education and research in the field and to encourage efforts to address the problem by doctors, patients and health care organizations
The nonprofit organization provides patient resources and a toolkit to help prepare for a doctor appointment at www.improvediagnosis.org .
Dr. Andrew Olson is an assistant professor of medicine and pediatrics at the University of Minnesota Medical School, as well as co-chair of the Education Committee at the Society to Improve Diagnosis in Medicine. He said one of the best strategies to improve diagnostic reasoning is to identify cases when diagnosis has gone wrong and to learn from them.
The reality, however, is that many medical schools do not have courses focused on the diagnostic process.
Medical schools are beginning to come to the importance of diagnostic education, but surveys show more attention is needed, Olson said. At U of M, for example, he leads a class on diagnosis that teaches medical students through real-world cases.
Another important lesson for doctors is working with patients and engaging them in the diagnostic process, Olson added.
Finding a solution to diagnostic error will involve collaboration among patients, family members and a range of health care workers, according to a 2015 report, "Improving Diagnosis in Health Care," from the Institute of Medicine of the National Academies of Sciences , Engineering and Medicine.
The report identifies steps to reduce errors such as:
Develop organizational cultures in health care that support discussion and feedback.
Recognize the importance of radiologists and pathologists as part of a diagnostic team
Develop a monitoring to identify and learn from mistakes
Minnesota is one of several states with a law that requires hospitals and outpatient surgical centers to report medical errors. However, the list of 29 reportable "adverse health events" does not include diagnostic error.
Hospital Associations in Wisconsin and Minnesota also run voluntary reporting programs to monitor hospital quality – including patient surveys pertaining to timeliness of care and communication by doctors and nurses measures specific to diagnosis.
Lisa Drummond (left) poses with daughter Melissa Fauber in her New Richmond, Wis. home. Drummond, who was diagnosed with colorectal cancer in December 2018, said she wants others to learn from her story. Michael Brun / RiverTown Multimedia
It started for Drummond around two years ago with a change in her bowel movements. She was on antidepressants at the time after her son, Jeffery Fauber, died by suicide. Drummond, a longtime nurse, said she knew to look for the side effects – which included diarrhea. She went to her doctor, but she chose to stay on the medication. Then she said she started to feel fatigued
This time it was suggested that her diet was to blame. But as the weeks went on, she said she grew weaker and her abdomen became distended and painful. "Every time I go in I would tell my doctor something's not right. There's just something, I can not pinpoint it. "
She eventually had a colonoscopy that found microscopic colitis, or inflammation. Medication seemed to help, but Drummond said the pain would soon return. After the latest flare up, her daughter, Melissa Fauber, took Drummond to the emergency room.
A series of tests were ordered and, for the first time, a scan of Drummond's abdomen. That's when she said a tearful doctor pulled up a chair next to her bed
"She took my hand and said," Lisa, I hate to tell you this … your abdomen is full of cancer. "" [19659002DrummondsaidshehadmadepeacewithherpreviousdoctorsandhadnoillwilltothemMorethananythingshesaidshewasrelievedtoknowwhatwascausingherallthatpain
"I'm glad I know what I have now," she said, "and I can make a plan and we can deal with it."
Loved ones have been a source of support to Lisa Drummond ) since her cancer diagnosis. She is pictured with (front, from left) Loren Drummond, Alby, Jaxson, Zakary and Emily Fauber; and (back, from left) Melissa Fauber, McKenna, Starr and Allen Fauber. Submitted photo
Family has been a source of comfort for Drummond post-diagnosis. Her support network includes daughter Melissa and son Allen Fauber, friend Shelley Barr, as well as extended family and grandchildren Starr, McKenna, Julian, Jaxson, Zakary and Alby. But Drummond said she wished she had brought her ally sooner to advocate for her during the diagnostic process
A friend or family member can be a helpful resource when facing a health problem. For complex medical issues or if geography separates a patient from their loved ones, that's when a professional patient advocate can step in.
"Especially when it's complicated or you really feel like you need someone to explain the processes to you, it's always and a good idea to have someone in your corner, "said Jill Fitzpatrick, who runs a patient advocate business in Minnesota
Patient advocates offer a variety of services, from accompanying patients to appointments to helping navigate health insurance and billing woes
Fitzpatrick said she took a collegial approach when she saw a doctor who is respectful, yet firm: "I'm educated about you, you're educated about medicine. Let's work together to see that I have a positive outcome. "
Another tip if patients feel they are not being heard by their care provider is to look for a membership service phone number on their insurance card to ask about seeing another provider in their network, she said.
Drummond said she does not want to scare anyone into mistrusting doctors and let people know there is no shame in seeking a second opinion. She said she regrets not seeking one sooner.
"And your doctor should not be offended," she added. "If they're offended, they're probably not the right doctor for you."