This Epidemic of Diagnostic Errors is Putting Lives at Risk in the U.S. (Shutterstock)

According to a new study at the Mayo Clinic, patients who get a second opinion at the Mayo Clinic get their diagnoses completely changed or redefined 88% of the time.

The Mayo Clinic in Rochester, Minnesota is perhaps the best diagnostic center on the planet. When many doctors across the United States simply cannot diagnose the condition for one of their patients, they refer them to the Mayo Clinic.

When you fly into the Rochester, Minnesota airport, you will see airplanes flagged from scores of countries. People fly to the Mayo Clinic from all around the world for care. They do that because of the amazing ability of the Mayo Clinic doctors to diagnose patients correctly and to prescribe the safest and least invasive way to treat their health problems.

 

How does Mayo do it so well?

The Mayo model is no big secret. When patients are evaluated at the Mayo Clinic, they are evaluated by a team of specialists representing the various health issues the patient has. Most patients referred to the Mayo Clinic have complex health conditions, meaning they have multiple co-morbidities. Further, after the patient has been evaluated by the specialists, their team will meet and come up with a consolidated diagnosis. Also as a team, they will prescribe the best treatment plan for the patient’s conditions, carefully considering all the comorbidities that the patient has.

The point of explaining all of this is to say that when Mayo speaks, people need to listen.

According to an article written by Daniel Steingold and published in Health Studies, in a study of patients with “serious” illnesses, a second opinion by Mayo doctors changes or refines the diagnosis 9 out of 10 times. Whoa! That is about an 88% diagnostic error rate!

Steingold writes, “‘Effective and efficient treatment depends on the right diagnosis,’ says lead researcher Dr. James Naessens in a Mayo news release.

 

There’s an epidemic of misdiagnoses

In America today, there is an epidemic of misdiagnoses. This epidemic of diagnostic errors is putting patients’ lives at risk. Additionally, this high rate of misdiagnoses is costing a fortune, as well as harming a huge number of people.

According to the National Academy of Medicine,

Despite the pervasiveness of diagnostic errors and the risk for serious patient harm, diagnostic errors have been largely unappreciated within the quality and patient safety movements in health care.

To repeat, this huge scale of diagnostic errors is largely unappreciated.

People talk a lot about healthcare quality. The biggest and most pervasive healthcare quality failure is to incorrectly diagnose the patient. If you been misdiagnosed, everything that follows will result in harm to you.

When I give speeches, I often ask the audience for a show of hands of people who have seen someone in their family experience a serious misdiagnosis. Usually, about 90% of the hands of the room go. Interestingly, people in the audience are usually surprised to see how many hands go up.

I have been referring people to the Mayo Clinic for three decades. These newly published data fit very well with the results of people whom I sent to Mayo. Over the years, I referred hundreds of transplant cases to the Mayo Clinic. Of the patients I personally sent to Mayo, it was determined that about 40% had been previously misdiagnosed and simply did not need the organ transplant that had been prescribed. Most left Mayo with no surgery at all.

The misdiagnosis rates for spine surgery cases has been about 75%. I could go on and on.

This is but one of the many reasons company-sponsored wellness and prevention has failed. Typical wellness and prevention programs are powerless to prevent you from being utterly misdiagnosed. Period.

Mayo isn’t the only health system that knows how to diagnose people accurately. They are the biggest and most famous. Intermountain in Salt Lake is good. So is Virginia Mason in Seattle; Kaiser; and Mercy in Springfield, MO, for orthopedics and cancer, to name a few. Part of what causes such places to do superior diagnostics is that their doctors are accountable.

 

Too big to ignore

This misdiagnosis rate in the U.S. is too big to continue to be ignored. The future of success in population health management will be to take steps to make sure covered members in self-insured benefit plans have access to top-quality second opinions.

The reason most earlier attempts at second opinion programs failed was because people were getting second opinions too often from local doctors who also had very high rates of misdiagnoses.

For the record, people don’t go to the Mayo Clinic for a second opinion on colds and sore throat and upset stomachs. If those kinds of conditions are misdiagnosed, it usually doesn’t make much difference anyway. People who go to Mayo usually have complex conditions. But those “outliers” are the ones who are spending 80% of plan dollars in a given year.

If you want to maximize care and cost savings on such outliers, you need to make programs available to ensure they are diagnosed correctly and offered optimal treatment plans.

Tom Emerick
Thomas G. Emerick is the President of Emerick Consulting, LLC and Host of Cracking Health Costs. Tom´s years with Wal-Mart Stores, Inc., Burger King Corporation, British Petroleum, and American Fidelity Assurance Company have provided an excellent blend of experience and contacts. His last position with Wal-Mart was Vice President, Global Benefit Design. Tom has served on a variety of employer coalitions and associations, including being on the board of the influential National Business Group on Health, the U. S. Chamber of Commerce Benefit Committee, and many others. Frequently in demand as a speaker for benefits and health care conferences, such as the internationally known World Health Care Congress, Tom´s topics include strategic health plan design, global health care challenges, health care economics, and evidence-based medicine.

3 COMMENTS

  1. Mayo in Florida is excellent in disposing patients correctly. Very excellent. I’ve sent a large number of patients with complex health needs.

  2. Years ago I asked an opthalmologist why he quickly figured out what was causing my son’s eye problems. He answered because he knew from previous treatments what didn’t work. By the time patients get to Mayo, they have generally been seen by many other physicians, a cozy pile of date for a Mayo team to start. Altering a diagnosis does not categorically make the previous diagnosis “an error” which puts the patient’s life in danger.

    I really resent the “gotcha” tone of this article. Most physicians I know welcome help in diagnosing patients. Wouldn’t send patients to Mayo if they didn’t. To turn around and vilify them for “misdiagnosing” because Mayo adds additional information to the mix seems, well, pretty arrogant.

    The world rolled up into black and white is the fashion now, but when it comes to health care, very little is really black and white.

LEAVE A REPLY


All comments are moderated. Please allow at least 1-2 days for it to display.