Preventing Misdiagnosis: Biases and Patient Engagement

Even in the world of medicine, with up-to-date technology and the brightest minds in the field working to their best ability, mistakes can be made. One area that can be particularly hazy is in diagnosing a patient. Many factors can affect a physician’s diagnosis- preconceived biases, unclear communication, and even a patient’s lack of engagement can all lead to misdiagnoses, and in turn cause a patient to receive incorrect or insufficient treatment.

Physician Biases

In a study published in Perspectives on Medical Education, researchers set up a workshop with the aim to examine and hopefully do away with some of the providers’ existing biases. The thought was that if providers are made aware of their biases, they can make an effort to overcome them.

A cognitive bias can be based on any number of things, and is hard to pinpoint, as providers are usually not aware of these biases. A bias is an assumption made about another person based on, for example: gender, race, the way they talk, sexual orientation, age, disability, and so on. Unfortunately, these factors lead to misdiagnosis in many cases. In behavioral health, for example, black patients are twice as likely to be diagnosed with schizophrenia. Meanwhile, white patients are more likely to be diagnosed with depression or anxiety.

In the study mentioned earlier, it was discovered that providers most effectively avoided biases in diagnosing when they paused to examine said biases throughout the diagnostic process. It’s one thing to acknowledge that a bias might be present, and another to recognize a specific bias and dismiss it as such. There is no hard and fast way to eliminate bias in providers’ diagnostic routines. But acknowledging bias and making a concerted effort to dismantle these preexisting assumptions is a good place to start, and the more providers are made aware of and continue to work toward dismissing these biases, the better.

Patient Engagement

Another way in which a patient can be diagnosed incorrectly or insufficiently is a lack of engagement on the patient’s part. While providers should always be working to make a correct diagnosis to the best of their ability, things go more smoothly when clear communication is present. Nobody knows a patient’s symptoms better than the patient herself, after all.

Diagnostic errors lead to roughly 40,000 to 80,000 deaths in the United States each year. This is a startling number that, if it can be avoided, should be. It’s important, then, to understand factors that can lead to a missed or incorrect diagnosis.

In terms of patient engagement, it’s important for patients to remember that a healthcare provider is only human. They make diagnoses based on more than just test results; it’s a conversation between provider and patient. Sometimes even small details that might seem irrelevant can be helpful in reaching an accurate diagnosis. In a perfect world, a patient should be able to rely 100% on a provider’s knowledge; however, that’s just not the case yet. Patients can downplay symptoms, dismiss them as unimportant, or simply not communicate them adequately to their providers. This isn’t the fault of the patient, but rather of an imperfect healthcare system that relies on clear communication between patient and provider.

As a patient, you know your body best. Be open and honest with your provider. And providers, listen to your patients. Work hard to overcome biases that might lead to misdiagnosis. Only by recognizing these possible roadblocks on the way to a correct diagnosis can we overcome them.