Saturday, December 19, 2009
Survey Reflection:
My survey was about misdiagnosis and other medicine related diseases/donations. Some of the things I found interesting from the results of my survey were how little people knew about misdiagnosis. Everyone agreed that misdiagnosis could be the patients fault and that misdiagnosis could be fetal. However those are the only two things all my surveyors agreed on. The rest of my results were very scattered, almost a 50-50 split between the options, and that was why I didn’t use my survey results in my final research essay much. For example, only 56% of the people who took my survey knew that misdiagnosis is related to physician malpractice. I also found it interesting that only 48% of the people surveyed said they ask their physician questions when they have them after an appointment. That is an alarmingly low amount of people who speak up when visiting the doctor’s office! Some things I really regret not adding in the survey were questions to get to know who the people taking my survey. I added the ‘age’ question after a few surveys were already taken but after seeing other people’s surveys; I would have liked to add a question about the gender, and maybe ethnicity of the people taking the survey.
Final Research Essay

Throughout the years, all things related to human life have in some way evolved. One of the many things that has come a long way is the field of medicine. Physicians, hospital staff and even patients have started to rely heavily on the technology for the purpose of testing for cancers, diabetes, STDs, and numerous other diseases. However, what many people tend to overlook is the fact that physicians can incorrectly read test results leading to a misdiagnosis and a result in unnecessary treatment for a disease that the patient doesn’t have. Physicians can misread test results because they rely too much on the results they would normally see instead of thinking of other possibilities.
Misdiagnosis is more common than most people may think. “New York Times columnist Sanders says that misdiagnoses account for perhaps as much as 17 percent of medical errors.” (Diagnosis: Dispatches from the Frontline of Medical Mysteries). This can ultimately lead up to 80,000 deaths each year and therefore, misdiagnosis is known to be one of the top ten leading causes of death (Younkers journal).
I can personally relate to the topic of misdiagnosis because my cousin, Amit, was incorrectly diagnosed five times before finally being diagnosed with Neuroblastoma, a pediatric cancer. I was 14 years old at the time and remember Amit going to the hospital on numerous occasions and returning with a different medication and diagnosis each time. At first it was the flu, then an ear infection, followed by pneumonia, and then the physician said that he was simply lethargic and had a cold. The physicians finally had to take Amit’s illness seriously when he lost his vision because the tumor had wrapped around his optic nerve causing him to lose his vision.
When Amit was admitted to the ICU at the University of Michigan Hospital, I specifically remember one event which is a perfect example of the severe consequences of misdiagnosis can affect a patient’s life. When Amit was in ICU his younger brother, Aakash, came to see him, and my dad was giving Aakash an air ride above Amit’s bed and saying “Amit can you catch your brother?” Amit responded with the most heart wrenching response: “Brother, hold my hand…I can’t see you.” The tears rushed down the faces of everyone in the room. To hear a two year old utter those words was devastating.
The first step the physicians at University of Michigan Hospital took after finding out Amit had Neuroblastoma was to operate on his optic nerve to save some of his vision because they knew it was impossible for him to gain all of it back. After the surgery, Amit gained back 20% of his vision in his right eye but unfortunately could not regain any vision in his left eye. I interviewed my aunt, Rani, for this essay as it was her son, Amit, who went through this grueling process of misdiagnosis.
During my interview, I asked my Aunt Rani how misdiagnosis had affected her family and also asked how much strain the actual sickness on the family. While responding, she became very emotional and I could hear her voice starting to crack, “Amit was sick for a whole month and none of the doctors we visited ever thought or considered doing a CAT scan until we suggested it our self. The misdiagnosis process was stressful because we were giving Amit medication but nothing would seem to work. My husband, Raj, and I would constantly fight with each other because we were blaming ourselves for Amit’s sickness. Till’ this day I still wonder if finding out a month earlier, when we started going to the doctors, would have made a difference and maybe saved Amit’s vision completely.” (Rani Sanghvi, interviewee).
In my survey, I asked if anyone else had experienced some type of misdiagnosis in their family. Of the 24 people who took the survey, eight said they had experienced some kind of misdiagnosis whether it was themselves or a family member.
The entire diagnosis process can take place in clinics, hospitals, emergency rooms, and anywhere else that physician/patient interaction takes place. The most common place for a misdiagnosis is in an emergency room and in an Intensive Care Unit (ICU). This is a scary thought because that is where most dangerous or life threatening situations take place and knowing that the physician could incorrectly diagnose you and potentially kill you is not a comforting thought! This was also one of my survey questions and very few people knew that the emergency room is the number one place for misdiagnosis. In fact, of the 24 people who participated in my survey, very few knew actually knew any facts about misdiagnosis.
Some misdiagnoses can lead to unnecessary treatment which could ultimately result in fatal outcomes. One article that stuck with me started with a case study in which a patient was experiencing dizziness and went to the hospital. When he arrived there, the physician requested a MRI and after briefly examining the results he found what he thought was a tumor. The physician was going to start the patient on medication and eventually operate on the “spinal tumor” however “The trouble was, he didn’t have a tumor at all, and the treatment offered to him would have most certainly paralyzed him and possibly killed him” (Second Opinion Can Save Lives, Cut Costs).
While many people are not well versed in the topic of misdiagnosis, malpractice is a far more common topic that has been popularized by the media and helped patients understand their rights within the physician-patient relationship. Malpractice is actually related to misdiagnosis; malpractice is a professional wrongdoing that could potentially result in injury or damage. A large proportion of malpractice cases are based on misdiagnosis or other related treatment lapses. As mentioned earlier, physicians often rely too much on the results of tests and what they would normally see with certain results instead of thinking outside the box – this results in many cases of misdiagnosis. Misdiagnosis also places an unwarranted strain on the health care system. An article, written by Evan Falchuk, states that “as much as 30% of the United States care costs are attributable to misguided medical care.” Misguided medical care could be caused by misdiagnosis because if a person who does now have cancer is diagnosed with cancer, their medical insurance is paying for the very expensive chemotherapy and radiation therapy. My aunt Rani up to 150 dollars on her regular doctor visits with Amit, and that was just the co-pay. Getting a second opinion in the given case could save lives and substantially cut costs.
As any other case, there are two sides to every misdiagnosis - it’s not simply the physicians fault every time. There are many other factors that could result in this unfortunate case of misdiagnosis. It can occur because there are so many different symptoms that a person can have and so many different diseases that relate to each of the symptoms. Therefore, it’s often difficult to correctly categorize symptoms with diseases and chose the right combination of the two. In the case of misdiagnosis, many malpractice lawsuits are unfair because the incorrect diagnosis could be the patients fault. How so? Well, patients don’t always tell the physician all their symptoms because they may be embarrassed or just simply overlook them. Misdiagnosis occurs because there are so many different symptoms that a person can have and so many different diseases that relate to the symptoms. Therefore, it’s often difficult to correctly categorize symptoms with diseases and chose the right combination of the two.
Regardless of whom is to blame, misdiagnosis is an extremely sad consequence of a lack of “duty” from the physician, the patient or a mixture of the two. We must be aware of the problems involved in the health care system and try our utmost to protect ourselves, especially from something as serious as misdiagnosis. Misdiagnosis leads to unnecessary costs, wasted time, and possibly incorrect or unnecessary treatment. In the case of Amit and his fight with Neuroblastoma, it’s not the money, cost or the excessive time spent in the hospitals, but the pain her went through and the hurtles he must overcome because of his vision which hurts the most. Misdiagnosis is a very unfortunate case in the medical field but is preventable. In my survey I asked if the participants ask questions, if they have any, when they go to the physician’s office. An alarming rate said they do not ask question - asking questions and becoming knowledgeable is one of the easiest ways to prevent misdiagnosis.
**Follow up on Amit: Amit has been in remission from Neuroblastoma for eight years now. The chances of his cancer coming back are very, very slim. He has lost some of his vision; he’s at 15% in his right eye and still no vision in his left. Amit goes to New York every six months for scans to detect any traces of cancer so it can be caught in the early stages if it ever does come back. My aunt Rani says that things are hard with Amit because he wants to do the things a normal 10 year old would want to do but he can’t because it takes him twice as long as his brother to do his homework, then he has to practice brail, and finally Amit has to memorize 50 spelling words a week. Amit’s parents are constantly looking for new technology that could help their son live a more normal life.
Work Cited
Katherine K. Matthay, Judith G. Villablanca, Robert C. Seeger, Daniel O. Stram, Richard E. Harris, Norma K. Ramsay, Patrick Swift, Hiroyuki Shimada, C. Thomas Black, Garrett M. Brodeur, Robert B. Gerbing, Patrick Reynolds,“Treatment of High-Risk Neuroblastoma with Intensive Chemotherapy, Radiotherapy, Autologous Bone Marrow Transplantation, and 13-cis-Retinoic Acid” The New England Journal of Medicine. Volume 341, 14 Oct. 1999
Joanna Weinstein, Howard Katzenstein, Susan Cohn, “Advances in the Diagnosis and Treatment of Neuroblastoma” The Oncologist, 2003
GM Brodeur, R Seeger, A Barrett, F Berthold, R Castleberry, G D'Angio, B De Bernardi, AE Evans, M Favrot, AI Freeman “International criteria for diagnosis, staging, and response to treatment in patients with neuroblastoma” Journal of Clinical Oncology, Vol 6 1988
Kieran McHugh “Renal and Adrenal Tumours in Children” Cancer Imaging. 5 March, 2007
GM Brodeur, J Pritchard, F Berthold, N Carlsen, V Castel, R Castelberry, B De Bernardi, AE Evans, M Favrot and F Hedborg, “Revisions of the international criteria for neuroblastoma diagnosis, staging, and response to treatment” Journal of Clinical Oncology 11 1993
“Gene That Regulates Tumors In Neuroblastoma Identified” Science News, 8 June 2009.
Chavez, Donna. "Diagnosis: Dispatched from the Frontline of Medical Mystery." The Booklist 105.15. Print.
Evan Falchuck. “Second Opinion Can Save Lives, Cut Costs.” Benefits & Compensation Digest 46.10. Online Data Base
Anonumous. “Don’t be a Diagnostic Error.” Consumer Reports on Health, Yonkers” 21.9. Online Database
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