19 November 2019
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Oh doctor I'm in trouble

Dr Ross Walker
30 July 2019

The common’s cause of death and disability in the world is cardiovascular disease — it keeps me in a job. Coming in second and closing in fast is cancer and disturbingly, the third biggest killer in the developed world is western healthcare. Over the past decade, there has been increasing evidence emerging regarding the concerns around harm from modern medicine. It is estimated that anywhere between 40-80,000 deaths per year occur purely from misdiagnosis. It is also estimated that somewhere between 80,000 to 160,000 serious cases of harm occur, again, from misdiagnosis.

The Johns Hopkins Medical School published recently in the Journal Diagnosis analysed 11,000 cases from the extensive data base from US malpractice. It may surprise you to learn that there are over 10,000 diseases affecting modern man, which can each manifest with a variety of different symptoms and signs making an accurate diagnosis very difficult in many cases. The researchers refer to the “Big 3” being cancer, cardiovascular disease and infections accounting for three quarters of all cases of serious harm related to misdiagnosis. Of all cases of misdiagnosis, death or disability from cancer account for 1/3, cardiovascular issues 22% and infections 13.5%. The most serious type of infection, sepsis, accounts for most cases of misdiagnosis in this category.

Typical scenarios of misdiagnosis include missing the symptoms and signs of heart attack, meningitis, pneumonia, blood clots occurring either in the legs or lungs, misdiagnosing skin cancers and missing prostate and breast cancers. Interestingly, but not surprisingly, is that in the emergency situation, cardiovascular disease and infections are misdiagnosed whereas cancers are often missed as outpatients.

It is important to understand that this study comes from the malpractice data base and not from the original medical records and thus the results certainly may be skewed.

The second study comes from the University of Manchester published in the Journal British Medical Journal-Today, reviewing 70 observational studies including 337,000 patients who were mainly adults. They looked at 28,150 cases where a person underwent harm from medical intervention, where just under 15,500 were calculated as preventable.

Basically, this study suggested that 1 out of 20 people involved in the medical system were affected by preventable harm of which 12% led to permanent disability or death. Half of these included the mistaken prescription of medications and complications from invasive procedures.

To some extent in defence of my noble profession, many of these people would have been seriously ill and may have died from the underlying condition without medical intervention. But doctors are in a powerful position to provide care but also induce harm. Although I believe it is vitally important that we maintain a long-term relationship with a trusted doctor as part of our life management team, it is also important that each person becomes their own advocate, asks questions and is fully educated as to their  possible diagnoses and treatment options. It is important also to ask questions regarding the risks of investigations, along with the possible side effects & complications of all the potential therapies.

It's your body, ask the right questions!

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