It seems like almost every month we hear about another patient being sent home, with tragic consequences, after visiting doctors and/or hospitals numerous times. It’s natural that families want answers, and they are entitled to them. They’re also right to advocate for patients trusting their instincts and getting second opinions.
Luckily in Australia, those fatal cases, and cases of outright medical negligence, aren’t the majority. More often than not, doctors do get it right – but it isn’t always easy.
Human bodies are complex, and that’s the first reason why doctors don’t always get it right the first time. Here are some of the other complicating factors in doctors making a diagnosis, as explained to Mamamia by health professionals (whose jobs forbid them from being identified).
Doctors often don’t have all the information they need immediately.
The medical history of the patient, including that of the patient’s immediate family, is often very relevant. In the context of this information being absent, doctors rely on assessing the symptoms as they’re presented, or they use a process of elimination for a diagnosis. They may send patients home to monitor temperature or perform blood tests for greater certainty. Until they know more, they can only use their experience to make an educated ‘guess’ as to what the problem might be.
No one is perfect.
There’s no job on earth that people can perform perfectly every single time. So sometimes things are overlooked, or not immediately thought of – and this doesn’t mean the doctor is negligent but merely human.
Listen to model Bec Craven speak to Mia Freedman, about catching a cold overseas that eventually led to a heart transplant. Post continues after audio.
It could be one of several issues.
Out of the millions of things that can go wrong with the human body, many of them have almost the exact same symptoms. This can make an instantly accurate diagnosis sometimes impossible.
Another factor is that some diseases only declare themselves over time; so their initial symptoms could be misleading.
Some patients are uncomfortable disclosing everything.
Does a parent feel they might be judged if they reveal their child never ever eats vegetables? Does a patient feel their diet, weight or sex life might be judged? Do they decide to say they smoke occasionally when it’s really half a packet a day? Not being entirely upfront with a doctor makes it even more difficult for a proper assessment. It’s good to remember that doctors have seen, and heard it all – and care much more about your future health, which they can do something about, than your past behaviour – which can’t be changed.
Some patients feel embarrassed about their symptoms or lifestyle.
They must refer you to a specialist.
In the same way that a maths teacher isn't normally fully prepared to teach a class on Wuthering Heights, most doctors aren't specialists in every field. Given the complex nature of the human body, that would be impossible. So patients are frequently referred to a specialist - the problem with that being the system is so overloaded wait-times for specialists can be weeks or months.
GPs sit at the centre of our world best universal healthcare system with @ABSStats data showing high levels of patient satisfaction. I think GPs better value for money than anything else in life! #auspol https://t.co/lFPYLtt7QJ
— AMA President (@amapresident) November 14, 2017
The doctor needs more time when they see you.
If they're already running an hour late due to giving each patient extra attention, it's difficult for the doctor to continue that for the rest of their session. They may have to call patients back for another time. If you think this might be the case, book a double appointment, even if it takes a little longer to be seen, it may be worth it in the long run.
Emergency departments are under immense pressure.
Even in Australia, hospital emergency departments are under-staffed and not equipped to meet the demand of so many patients. The point of emergency departments is to ensure a patient isn't dying immediately, and doctors are under immense pressure to turn over patients quickly. There's actually an unspoken "four hour rule" and staff are expected to meet it. If you think you need detailed medical attention for an ongoing problem, you'd be better off seeing a General Practitioner.
Doctors and specialists are constantly having to manage mutliple jobs.
Red tape and privacy.
The public may not always be aware that doctors don't have access to all of their medical records, despite being identified by a Medicare number wherever they go. The general public would be surprised to know how decentralised health information is. Bureaucracy often comes into play - and there are times when services actively prevent or block information sharing due to privacy restrictions.
Using the 'retrospect-o-scope' is impossible at the time.
Yes, that's actually a term doctors use. In hindsight, after an event, things are often suddenly obvious to everyone. The practice of medicine is ever-evolving, and despite the best intentions at the time, mistakes are bound to be revealed in retrospect.
The best we can do as patients is arm the doctor with as much information about ourselves as possible, question them, pay attention to our bodies, and speak up when our instincts tell us to, so that the factors preventing doctors getting it right the first time are hopefully not as relevant.