Ideas on improving rates of missed/delayed diagnoses in PCP type visits.

Janel Hopper janelhopper at COMCAST.NET
Fri Jan 10 16:27:36 UTC 2014


Here here, Victoria! (Or is it "hear, hear?)

I concur with your remarks.

Obamacare is supposed to provide for patient feedback whether they are satisfied with their service. The questionnaires that I receive ask about hand washing and being on time. They ought to ask whether the doctor got the DX correct, treated the patient with respect, or showed a willingness to engage with the patient who might being in relevant medical literature.

I worked out my own diagnosis and now the institution is claiming I was never symptomatic. Because of the specificity of the antibodies, the pernicious anemia DX is indisputable. 

If I was and supposedly am asymptomatic, what drives me to the doctors trying to get GI help? 

According to these experts, the test that shows I have no stomach acid, well that's true. They don't dispute that. But I have been pronounced by them asymptomatic.

I participate in a pernicious anemia newsgroup. Doctors in other countries review information and figure out what was missed along the way. Not here.

Irrational system. Only protecting doctors and institutions. Not patients.

Janel

Sent from my iPhone

> On Jan 10, 2014, at 7:14 AM, Victoria Nicholls <nichollsvi2 at GMAIL.COM> wrote:
> 
> So far, I've not seen any indication that there is a willingness to
> take responsibility for changing the way diagnoses are given. I've
> asked my doctors to perform certain tests to rule out and/or prove my
> medical literature and they won't. That indicates 1) an attitude
> problem or 2) a knowledge problem. If I'm bringing the knowledge in
> the form of medical literature to the table, then it can't be #2.
> 
> I've heard the comments regarding a system issue. Then why isn't a
> system issue getting fixed? What are the system issues? I believe I've
> put one out already and that is in how doctors are trained, the
> inflexible attitudes that come with diagnosis set in stone, when
> that's not necessarily true.
> 
> Victoria
> 
> 
>> On Fri, Jan 10, 2014 at 1:29 AM, Karen Cosby <kcosby40 at gmail.com> wrote:
>> This is a sad example not so much of medical misdiagnosis but rather an
>> inflexible and unfair legal/insurance industry.  The physician may have
>> simply asked for a consultation with a question of pericarditis that the
>> insurer failed to dismiss even with clear evidence of good health.  I was
>> rated as an insurance risk because of high blood pressure during pregnancy
>> (preeclampsia) that has had no bearing on my health since, costing me
>> thousands in insurance premiums ever since.  That's not an issue of
>> misdiagnosis as much as a problem with how medical information can be
>> misused and misunderstood.  Once again  this is an example of people
>> assuming that every diagnosis is final, absolute, and constant.  It really
>> seems to me that we need to find a language that communicates better where
>> we are in the process of diagnosis (perhaps "diagnosis under consideration",
>> diagnosis pending further evaluation, versus diagnosis established).  I have
>> been surprised to have a number of conversations with lay people who are
>> shocked that any one would challenge a diagnosis they've been given as if
>> all diagnoses are established with absolute certainty.
>> 
>> 










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