Consider full diagnostic process to prevent misdiagnosis
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PHILADELPHIA — Misdiagnosis is responsible for the deaths of 40,000 to 80,000 individuals in all of medicine each year, according to a speaker here.
“The stuff that we miss are the easy things,” Tamara R. Fountain, MD, said during the Richard A. Ellis Lecture at the Wills Eye Conference. “We miss them not because we don’t know about them — we miss them because we don’t look for them.”
Fountain said that the diagnoses most commonly missed by ophthalmologists are retinal detachment, glaucoma and intraocular foreign bodies.
“When we are missing diagnoses, at least according to OMIC stats, we are not missing the exotic zebras,” she said.
To prevent misdiagnosis, Fountain said it is important for physicians to not “forget to treat the patient.” This often means looking for clues hidden in plain sight, as well as asking questions such as, “Why is the patient not better, what else could this be, and if I’m wrong, what don’t I want this to be?”
“I think as physicians, we tend to focus on this part of the diagnostic process — generating our differential diagnosis and ordering appropriate testing,” Fountain said. “It’s what is drilled into us during medical school, but we can’t forget the other parts of the diagnostic process.”
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Fountain TR. Richard A. Ellis Lecture: Pilots and physicians, passengers and patients: Making crucial decisions when stakes are high. Presented at: Wills Eye Conference; March 10-12, 2022; Philadelphia.
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