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Study: Shorter visits at the doctor’s office leading to misdiagnosis

Dr. Hardeep Singh, MD, MPH, Assistant Professor of Medicine at the Michael E. DeBakey Veterans Affairs Medical Center, recently conducted a study on the quality of treatment patients receive during primary care office visits.

His research essentially determined that many primary care physicians are misdiagnosing patients. The reason is likely due to shorter patient office visits and the lack of time devoted to adequately assess their patient's conditions.

The study

Dr. Singh and his staff examined over 212,000 medical records of patients from four different healthcare entities including one Veterans Affairs facility. From these records, they investigated instances where patients were subsequently hospitalized or visited emergency rooms after the initial visits to their primary care physicians.

They scrutinized these subsequent visits to find out why these patients needed follow-up care. They determined it was because their conditions were misdiagnoses at their original appointments.

Reasons for primary care physician misdiagnosis

Based on the data, they found numerous reasons behind the misdiagnoses including:

  • Physical exams that were improperly conducted
  • Patients' past medical history that was improperly collected by the healthcare entity
  • Referral consultations that doctors failed to order
  • Patient lab results that were not followed-up on
  • Patient lab tests that were not read
  • Communication between patient and medical staff that was found deficient

Researchers determined that all of these were likely because of the lack of time available to provide to patients.

According to Dr. Singh, communication today between doctors and patients is shortening. "We're talking less to patients and those skill sets and techniques of getting the history and examination of the patient are going a bit downward," he says.

Mitigating the potential for misdiagnosis

Dr. David Newman-Toker, a neurologist at Johns Hopkins Hospital who was invited to comment on the results of the study, says that these instances can essentially be mitigated and doctors can take measures to reduce these occurrences.

His advice to primary care physicians today: "Focus on the things that matter. Create for yourself a short list of things for a given list of complaints that are problems that you cannot, for the patient's sake, ignore. Go through that list at the encounter with a patient, or if the problem is not responding to treatment the way you thought it should."

The study was recently published in the JAMA Internal Medicine-an online medical journal that offers data on research studies to individuals in the healthcare field.