September 23, 2010

Medical Mistakes, Real and Imagined

Many people think their doctors made an error. Whether it's true or not, patients often switch doctors as a result.

According to a new study from UNC Chapel Hill, many people feel that their doctor made a mistake in diagnosis or treatment of their condition. Whether the mistake actually happened or is not always clear, but patients can be quick to switch doctors as a result of a perceived. "mistake"

About 16% of people felt that their doctors had made some sort of mistake. Of these, about two-thirds said that they had changed doctors because of the perceived mistake

The researchers surveyed almost 1,700 people from cities, suburbs, and rural areas, asking them questions about their histories with medical doctors. First, they asked them about their overall experiences with healthcare. They also asked whether a doctor error had been made, and if so, whether it was in the diagnosis or treatment of the person’s condition or disease. And finally, participants told the researchers whether the perceived mistake had prompted them to switch doctors and seek alternative care.

Christine E. Kistler and her team found that about 16% of people felt that their doctors had made some sort of mistake. Of these, about two-thirds said that they had changed doctors because of the perceived mistake. Another 13% of participants said they had been misdiagnosed by their doctor, and 13% said they had received in incorrect treatment.

The most common types of perceived mistakes had to do with communication problems between doctors and patients, but participants also reported that "possible adverse effects" or "near misses" had taken place.

Though the study could not measure whether the mistakes had actually occurred or were just perceived, when the researchers asked the patients about their specific experiences they got some interesting stories. One person told them, "I had a rash all over my legs and stomach and back. The doctor said it was just an allergic reaction to something, but it wasn't getting better. I went to a dermatologist and found out that I had psoriasis." Another patient told the researchers, "I had a swollen lymph node under my arm; it was very tender. I went to my main doctor, who sent me to a specialist, and that doctor wanted to take off my breast. I wanted another opinion. I got one, and that doctor sent me for a mammogram and biopsy of the lymph nodes. It turned out I had ‘cat scratch fever.’"

Interestingly, white participants and those who were more educated perceived mistakes more than other groups of people. The only condition that was particularly associated with perceiving mistakes more frequently was chronic back pain, but people who had poorer overall health were also more likely to find fault with their doctors. The authors suggest that the findings will be useful to doctors, since knowing which groups of people are more apt to perceive mistakes will help clinicians better "set expectations". The results may also ultimately help strengthen the doctor-patient relationship, which other studies have suggested may have weakened in recent years.

The study was published in the September 13, 2010 issue of Archives of Internal Medicine.

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