Friday, March 16, 2012

Misdiagnosis

As doctors, it's inevitable that we get probing questions about medicine.

Yes, even from relative strangers at the very first meeting seconds after that introductory handshake. Since general medicine basically governs everything that happens to your physical body, it's a subject that's reasonably close to everyone's heart.

And everyone's all too willing to share confidential information. Reasonably circumspect fellows would suddenly have zero qualms about baring their innermost secrets, not only about that dark secret ( possibly venereal ) wart they have hidden up in their inner thigh, but also about every other medical professional they have ever met in their lives.

Patient : I don't know if you know him but...
Paul : Not really, I mean we don't have a secret clubhouse, but why? Do you have a complaint about that doctor?
Patient : Yeah, there are rumours that he usually comes up with the wrong diagnosis.
Paul : Well that actually does happen.
Patient : How can la liddat!
Paul : Hmm... how do I explain? It's almost like throwing a dart at a board. Blindfolded.
Patient : Aiyoh!

Actually I've got a simpler answer.

Doctors are not God.

David Gandy
Hmm.. what in the world does this patient have?

No matter how much some of us ( looking at ya, cardiac surgeons ) wish we are. Although we might be pretty sure about our provisional diagnosis, that doesn't mean it's a 100% absolute. There's always some margin of error. Even more so when the signs and symptoms are oddly non-specific.

Yes, mistakes can and will be made.


But look, even the renowned physician Gregory House gets it wrong. Even with an entire highly specialized team of medical experts, a plethora of diagnostic scan machines and a reasonably intelligent patient with surprisingly specific symptoms. And obviously it doesn't actually take only half an hour to come to the correct conclusion.

Even then, they usually get it all wrong. Test the wrong drugs, try the wrong treatments, experiment with the wrong trials - usually ending with the terribly unfortunate patient almost at the brink of certain extinction.

So yes, doctors do make the wrong provisional diagnosis. Fortunately most of us also have an exhaustive list of differential diagnosis to follow.

6 comments:

Aiden said...

*like*

Anonymous said...

sometimes, not all the pieces fit together right? they might have a combo of illnesses. some patients just have unrealistic expectations...

GVP said...

I totally agree with you. Human error is inevitable. People are not perfect, and we make mistake despite our best effort. I guess at least we learn from it and try to make sure that the same mistake is not repeated.

We are having rotations around the vet hospital at the moment. There was almost incident of injection a drug 10x the recommended dose, but luckily we noticed that (just before the injection).

Tempus said...

people EXPECT. people DEMAND. See how education make people?

haha, oh well, doctor ain't as high and mighty and all knowing as before.

Just like teachers, the "doctor" aka teacher of medicine no longer have the respect people used to give.

Kenny Mah said...

What matters is that one does the best one can, and I think doctors are already under so much stress to perform and to be near-perfect...

One of my doctor friends wrote recently about how one of her greatest (and unexpected) rewards on the job was a handwritten thank-you note by a former patient. So there are days mistakes are made, and then there are days when good work is appreciated.

savante said...

Agreed, aiden and anon. Sometimes it's really hard to pinpoint on one particular diagnosis.

Some treatments will go wrong but hopefully they realize it early rather than late, gvp.

Still respect teachers quite a lot, tempus. It's the parents these days that I've lost respect for.

Oh yes, the best are the notes from the patients, kenny. Not to mention the cempedak and durian :P

P