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Patient satisfaction issues can arise from misdiagnosis

Looking to improve patient satisfaction? Be aware of problems people may experience when seeking a diagnosis

Misdiagnosis and failure to diagnose are among the patient satisfaction issues that could negatively impact your practice. In fact, according to The National Trial Lawyers: Top 100, the largest percentage (33%) of malpractice allegations are due to misdiagnosis.1

But patient satisfaction issues aren't always tough to tackle. Here are some insights into what your patients may be thinking when they receive the wrong diagnosis or no diagnosis at all, and what you can do to improve their peace of mind.

Frustration when a doctor gets it wrong

When patients have health problems, they want accurate diagnoses and answers to their questions so they can get started with appropriate treatment plans. Occasionally, information gets lost along the way, or misinterpreted, and the diagnosis is incorrect. Other times, a patient could present with several inconsistent symptoms that may not point to the accurate diagnosis of a disease.

If you think patient satisfaction issues in healthcare don't arise from these types of circumstances, think again. It can be extremely frustrating to feel sick and be given the wrong answers or no answers at all. Some patients may never return to a physician who misdiagnoses them.

Inaccurate diagnoses aren't just frustrating causes of patient satisfaction issues, they can also result in serious medical errors, cause patients to lose precious time in pursuit of the correct diagnosis or even result in loss of life.1

Where errors happen

In the United States, approximately twelve million patients in primary care settings experience diagnostic errors, with 33% resulting in substantial or lasting physical damage or even death. Over the course of a decade, these severe cases paid out $1.8 billion in malpractice claims.2

A study funded by the Society to Improve Diagnosis in Medicine that analyzed more than 55,000 malpractice claims, found that the majority of mistakes causing the most harm fell into three major categories: cancer, vascular events and infection. Topping those categories were lung cancer, stroke and sepsis.2

Other commonly misdiagnosed conditions include heart attack, depression, fibromyalgia, thyroid conditions, Lyme disease and celiac disease.3

Misdiagnoses can occur for a number of reasons. Doctors may have inadequate time with their patients due to over scheduling, they may not have all of the information they need to diagnose a patient or the patient's medical history may be incomplete.3

Approximately 12 million patients experience diagnostic errors in primary care settings.

Where are the lab results?

Not following up on lab test results can also leave a patient waiting for a diagnosis. Test result management can involve a variety of communication methods, some of which of can allow results to slip through the cracks. For example, an obstetrics/gynecology practice may send mammogram results by mail, while others notify patients via a phone call. Still others may notify patients electronically through an online patient portal or phone app.

What if the mail never arrives or the doctor's office leaves a message and the patient does not return the call or listen to the message? What if the patient does not know how to get his or her test results from an electronic medical record or doesn't understand the results without the doctor's assistance in interpreting them? And what if the patient assumed he or she never heard back about those results because everything was fine and there's nothing more to do (when, in fact, there is)? All of these issues can contribute to a patient's satisfaction level.

According to a recent study, "failure to follow up on laboratory test results is a significant concern and a priority patient safety area."4 These failures involve inconsistency in the management of test results, ambiguous policies and procedures about these results, and a failure to identify critical results or deliver them in a timely fashion. And how would a doctor know whether or not a patient has or has not received his or her results?

While electronic systems aren't perfect, the study indicates that the best chance for test result communication success is when IT interventions are combined with flexible laboratory testing management. These technology systems provide accountability in regard to improving quality and safety for patients, allow practices to commit to improved lab test management, and allow consumers to manage their own healthcare data.

In-office testing may also help keep test results from slipping through the cracks, as physicians and their patients receive lab test results during an initial visit when they're together. One study showed patients were very satisfied with in-office testing in an ambulatory primary care practice setting.5

Researchers found that nearly seven and a half months elapsed from the onset of symptoms to a cancer diagnosis.

Diagnostic delays

Sometimes it can simply take too long to arrive at a diagnosis, particularly when a condition is aggressive and life threatening. In a study on delays in the diagnosis of anal cancer and patient satisfaction, researchers found nearly seven and a half months elapsed, on average, from the onset of symptoms to a cancer diagnosis.6 It's possible for common symptoms that patients report could be typical of both cancerous and benign conditions — such as rectal and abdominal pain and blood with bowel movements.

In nearly half of the patients surveyed with these symptoms, their primary care physicians (PCPs) did not perform digital rectal exams. And in only 54% of first visits did these PCPs order further investigation. Twenty-seven percent of the doctors misdiagnosed the cancer as hemorrhoids at the patient's first visit.6

Most of these patients (78%) believed they had a delay in diagnosis, but according to the study, "as expected, more patients who did not believe the medical system was to blame for their delay in diagnosis were satisfied."6

Lastly, it's crucial to patient safety that physicians learn from their patients who have been misdiagnosed. While most research on diagnostic errors has focused on systems and physician decision-making, a recent study looked to patients and their families for new insights into what went wrong in the case of a misdiagnosis.7 The study found major problems arose from patient-physician interactions, including unprofessional physician behavior and "ignoring patients' knowledge, disrespecting patients, failing to communicate, and manipulation or deception."

All of this is evidence of how truly listening to patients, utilizing in-office testing and laboratory technology solutions can not only help improve patient satisfaction but also reduce unintended harm from diagnostic mistakes.


Be advised that information contained herein is intended to serve as a useful reference for informational purposes only and is not complete clinical information. This information is intended for use only by competent healthcare professionals exercising judgment in providing care. McKesson cannot be held responsible for the continued currency of or for any errors or omissions in the information.

© 2021 McKesson Medical-Surgical Inc.