My good friends, Joe and Terry Graedon, published an article yesterday on their website, The People’s Pharacy, about mistakes physicians make. In this article, they state that research shows that about 5% of diagnoses made by primary care physicians are erroneous, affecting about 12 million patients per year. Since this was a facebook post, I replied to this article (which is good and I highly recommend it). Here is my reply, which I want to share with my patients:

Joe and Terry,

Mistakes are inevitable in medicine, so no argument there, and are clearly made by doctors every day. The lisinopril example is not a mistake at all, but a common side effect that is impossible to predict ahead of time. The mistake would be the physician who doesn’t recognize it and react appropriately. Many symptoms that patients bring to physicians are not possible to link with a clearcut diagnosis, and require a lot of reiterative and cooperative interaction with the patient to either diagnose, or simply manage the symptoms or syndrome involved. So saying that the physician missed the diagnosis in such cases is inaccurate and unfair. I could provide you with a long list of symptom complexes that are virtually impossible to pigeonhole into a specific diagnosis.

Your list for patients to present to doctors is a good idea and suggests the best method for doctors and patients to minimize mistakes: by lowering the barriers to communication, creating an atmosphere of trust, and by encouraging the patient to take responsibility for their own care. By having this type of doctor/patient relationship, the patient will come to quickly realize that the doctor is not the “be all and end all” for their health, but is merely a resource that they should tap into to manage their own health.

As always, thanks for your stimulating and interesting article on this subject. I think I’ll follow up with a blog post about this issue for my practice web site.

Charlie

I would welcome questions or dissenting comments from any of you, but I think it is worth emphasizing these points: That I want to encourage you to ask questions, remind me about things, review your own lab results, be familiar with your diagnoses and medications and see if we agree that they are accurate, or if they need changing or deleting.

If you have been my patient for very long, you will know that I will listen and try my very best to identify the diagnosis behind the symptom or the lab result in question and, together, come up with the best treatment plan. And, you will also realize that sometimes I will forget a detail, or send a prescription with a minor error in it that needs correcting, or something similar to this. We usually do a good job of correcting these things and I never feel criticism or negativity from you, because I believe you realize that we are “in a partnership” and have to work together to achieve the best outcomes.

And, if you aren’t a patient and think this partnership sounds like what you are looking for, come see me!