Many patients automatically trust their doctor – assuming that he or she must always be right. But that can be a deadly mistake.
It has always been diagnostic skills which have differentiated between the good doctor and the bad doctor. Treating sick people is easy. If you are a doctor and you know what is wrong with your patient you can look up the correct treatment in two minutes. Sadly, however, many doctors seem to have lost their abilities to diagnose accurately.
1. When researchers examined the medical records of 100 dead patients who had been shown by post mortem to have had heart attacks they found that only 53% of the heart attacks had been diagnosed. What makes this even more alarming is the fact that half the patients had been looked after by experts in heart disease.
2. A study across 32 hospitals which compared the diagnoses doctors had made when treating 1,800 patients with the diagnoses made after the patients had died (and could be examined more thoroughly) showed that doctors had an error rate of nearly 20%.
3. A study of 131 randomly selected psychiatric patients showed that approximately three quarters (75%) of the patients may have been wrongly diagnosed.
4. In many cases patients are diagnosed as having – and are then treated for – serious psychiatric problems when their symptoms are caused by drugs they have been given for physical problems. Whole wards full of patients have been diagnosed, treated and classified as schizophrenic when in fact they were suffering from side effects produced by the drugs they had been given by prescription happy doctors.
5. When 80 doctors were asked to examine silicone models of female breasts they could only find half the hidden lumps. A 50% failure rate even though the doctors knew that they were being tested and observed. * Another study showed that doctors had missed diagnoses in dying patients up to a quarter of the time. Experts concluded that one in ten patients who had died would have lived if the correct diagnosis had been made.
6. Another study revealed that in two thirds of patients who had died, important, previously undiagnosed conditions were discovered in the post mortem room.
7. A report published after pathologists had performed 400 post mortem examinations showed that in more than half the cases the wrong diagnosis had been made. The authors of this report said that potentially treatable disease was missed in 13% of patients; that 65 out of 134 cases of pneumonia had gone undetected and that out of 51 patients who had suffered heart attacks doctors had failed to diagnose the problem in 18 cases.
All this is terrifying. For if the doctor doesn’t make the right diagnosis then it doesn’t matter how many wonderful drugs he has at his disposal.
There are many reasons why today’s doctors are so bad at making the correct diagnosis.
Education is often lamentable – with lecturers too often teaching medical students about organs and tissues rather than living patients, and then examining them on their ability to remember huge lists of details about bones, blood vessels and pathology details without ever testing them on their ability to use the information they have acquired.
And studies have shown that doctors are at their worst when dealing with patients with whom they feel uncomfortable. Narrow training means that doctors feel uncomfortable with a wide range of people. They often have difficulty relating to, talking to or acquiring information from people of ‘different’ races, sexes or social backgrounds.
An even bigger problem is the fact that modern doctors rely far too much on technology – and far too little on building up any diagnostic skills of their own.
Old fashioned doctors used to rely on what their patients told them and on what their own eyes, ears, noses and fingertips told them. Most important of all, perhaps, was the sixth sense that doctors used to acquire through years of clinical experience.
Modern doctors rely too much upon equipment which is often faulty, frequently badly calibrated and more often than not downright misleading.
For example, nearly every published study on the subject puts the error rate for doctors reading X-rays at between 20% and 40%. Radiologists working at a big hospital disagreed on the interpretation of chest radiographs as much as 56% of the time. And there were potentially significant errors in 41% of their reports. Even when X-rays are read for a second time only about a third of the initial errors are spotted.
So, the lesson here is a very simple one: do not automatically assume that your doctor’s diagnosis must be right. If you are at all unhappy about the diagnosis – and feel that your doctor could be wrong – insist on a second opinion.
Taken from the international bestselling book `How to stop your doctor killing you’ by Vernon Coleman
`How to stop your doctor killing you’ is available as a paperback and an eBook.
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Stop Press News
Dr Vernon Coleman
1. It has now been officially decided that in addition to the millions suffering from an imaginary disease called Long Covid, there are also millions suffering from Long Cold. It seems that all sorts of diseases may linger on for extended periods. I expect to hear within days that NHS staff, police and other public employees who have Long Dandruff can take time off work until their condition has been cured.
2. The BBC has apologised for a serious error on its website. `We inadvertently published a picture of a white man not wanted by the police,’ said a spokesperson. `We regret this error. The member of staff responsible has been dealt with.’
3. The BMA has called for an end to the treatment of sick people. `Looking after people who are ill takes a good deal of time and money,’ said a BMA spokesdoctor. `If we stopped wasting money on patients we could give doctors a 350% pay rise and they could stay at home and catch up with their Netflix watching.’
4. In all future elections, the ballot paper will contain an additional choice. Voters will be able to tick a box labelled `Fuck Them All’.
5. It has just been announced by the mainstream media (which only prints last year’s news) that Prince Bernhard was definitely a Nazi. That will come as no news to readers of my new book `Their Terrifying Plan’. This is what I wrote in the section about the Bilderbergers. `Named after the hotel where the conspirators first met in May 1954 (the Hotel de Bilderberg in Holland) the group was created by Prince Bernhard of the Netherlands, a powerful Dutch businessman, a friend of the Rothschilds and a former Nazi SS storm trooper who described his work for Hitler as a lot of fun and yet somehow managed to remain an eminent member of Dutch society after the end of World War II. Interestingly, Bernhard was a Nazi at the same time as Klaus Schwab’s father.’ In `Their Terrifying Plan’ I also pointed out that the honorary sponsor of the third Davos meeting of the WEF in 1973 was Prince Bernhard of the Netherlands (described as a former Nazi and the founder of the Bilderberger meetings). Read my book `The Terrifying Plan’ to find out what the mainstream media will be writing about next year.
6. The banning of single use plastics is rather odd because single use PPE is made with plastic. (I bet the plastic banners didn’t think of that.)
7. It makes good sense for governments everywhere to bring in euthanasia for the under 30s. Expect this to be introduced any minute now. `The under 30s use up far more energy than the over 60s,’ a spokesmoron will say. `Most of them will live for years and use up lots of oil and gas. It makes far more sense to euthanize the under 30s than to euthanize the elderly who will soon be dead anyway.’
8. The weather in England is now so hot that a fisherman in Staffordshire caught a ready cooked trout. `The river water was just the perfect temperature for cooking a fish,’ said the fisherman. `I threw away my sandwiches and had the trout for my lunch. A real treat.’ Two wild river swimmers who ventured into the same river are being treated for serious burns. `The water was so hot that my swimming costume melted,’ complained one swimmer.
When did this all start to change? I remember in the 80s that anytime anyone went to the doctor for anything, the question from all was, “Did you get a second opinion?”, or “You need to get a second opinion?” Or numerous others statements that a second opinion was necessary.
Roughly 20 years ago, a young naval doctor visited my medical school in Japan. One of the things he was doing was talking up two books he wrote specifically for Japanese MDs who wished to study or work abroad. I bought the set and the school has a couple of copies as well. He spoke at length of the overuse of testing in Japan, which I as a patient here can verify. He spoke of the most expensive, sophisticated medical diagnostic device they would ever encounter was their own brain filled with the medical education and experience. That they should not test if the results would not change treatment. To test just to see what is there is wasteful of time and money and that most of the time there are other ways to learn what one would through tests anyway. The books were to help train Japanese MDs in the thinking behind Western medical approaches to diagnosing.
For that past 20 or so years I have tried to instill these ideas in my students only to recently learn that apparently, the US medical system has turned Japanese; doctors can not begin to diagnose until the machine that goes “bing” spits out a reading. WTF happened back “home”?