Correct Diagnosis: 10 Steps Toward Getting it Right

Posted on November 1, 2022

Wait a minute what – the right diagnosis!?! Isn’t that assumed? The reality of health care is missed diagnosis, or diagnostic error “. . . inaccurate or delayed diagnosis-persist throughout all settings of care and continue to harm an unacceptable number of patients.” These errors stem from a wide variety of causes, one of which results from inadequate collaboration and communication among clinicians, patients, and their families. "Some fail to ask questions, or insisist on sticking . . .

Wait a minute what – the right diagnosis!?! Isn’t that assumed?

The reality of health care is missed diagnosis, or diagnostic error “. . . inaccurate or delayed diagnosis-persist throughout all settings of care and continue to harm an unacceptable number of patients.” [i]

These errors stem from a wide variety of causes, one of which results from inadequate collaboration and communication among clinicians, patients, and their families.

"Some fail to ask questions, or insist on sticking with a doctor who lacks expertise or interest. Others hopscotch among experts—although not necessarily in the right specialty—without consulting a primary-care doctor whose job is to make appropriate referrals and coordinate care."[ii]

To determine the correct diagnosis, physicians collect as much information as they can. Proactive patient/family/care partner that is prepared be involved certainly helps:

1. Be familiar with your medical history. Go through your family tree and look at what diseases and conditions run through it. If you don't know, ask your relatives. Conditions like cancer, heart disease, even depression, anxiety and others have a genetic component.

2. Keep your medical records current. Be sure to have copies of latest physicians and specialists visit summary’s, lab results, x-rays, scans, EKG’s, surgical and referral reports, and anything else that may be relevant. A notebook or binder with tabs helps with organization. Place most recent in front.

3. Know and Bring in Your Medications. You want to make sure you're taking the correct medicine at the correct dose. Medication errors return more people to the hospital than just about anything else.

4. Keep a Timeline. Write Down Each Symptom and Be Specific. Note when each symptom began, when it’s happening (first get up in the morning, after meals, etc.), how often the symptom occurs and how long it lasts. Try to get as precise as you can about what you're feeling. If you've got a pain, is it a shooting, sharp pain or a dull ache? Does it come and go after eating? How long does it last? A few seconds? A few minutes? How long have you had it? A week? A month? A year? Does anything decrease the pain?

Also, turn subjective data into objective. If you feel feverish, for example, take your temperature for a week nightly and write down all the information. [iii]

5. Prepare for Each Visit. Sit down at least once, preferably two or three times before your appointment, and write down what you want to talk to the doctor about.

6. Bring a trusted care partner with you. This can be your spouse, son, daughter or other trusted person who will take notes and ask questions you may not be thinking of. If you hear something disturbing, like, "It's possible this might be a tumor," you probably won't remember anything your doctor said, other than "tumor."

7. Once you have a diagnosis, don't be afraid to second guess your doctor. Are you sure this is what I have? What makes you think that?

8. Ask Your Doctor What to Expect. If your doctor does make a diagnosis, ask what you should expect and any red flags you should be looking for. Say you have a skin infection, and medication is prescribed. How long before you start seeing an improvement?

9. Plan for Your Appointment With Specialists. Get a list together of what's been done so far - any tests you've taken, X-rays, MRIs, labs, etc., and get copies of them. By law you're entitled to your medical records. To do that, call any health care provider you've already seen and ask for an authorization for the release of information form.

10. For new diagnoses, ALWAYS get a 2nd opinion. ALWAYS from an independent source – not from a referral from your doctor. Doctors who know each other tend not to question colleagues’ advice. Good doctors are not threatened by a second opinion, they're strengthened by it.

Finally: Question, Question, Question. There is no such thing as a dumb question when it comes to your health.

Don't be afraid to ask the doctor what s/he needs to make the diagnosis. Ask point blank: What do you need to get to the bottom of this? What's your list of diagnoses it could be? Are there other specialists, procedures, or tests that would help you make the diagnosis? When do you want me to make the next appointment and what information can I bring to help make the diagnosis? Is there a specialist I should see? And again, don't be afraid to ask for a second opinion.

Patients often worry that they will offend their doctor if they get a second opinion. But here’s the truth: good doctors encourage their patients to collect as much information as they can. They know the more information, the better any health care decisions.

Patient Advocates of Southwest FL

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Sources: Safe & Sound Diagnosis - The Care Partner Project; Avoid Misdiagnosis: 8 Ways to Help Your Doctor Make the Right Diagnosis (webmd.com)

[i] Improving Diagnosis in Health Care, 2015: Summary. Copyright National Academy of Sciences. 2015. P.1.
[ii] Advisory Board. How can you avoid becoming a ‘medical mystery’? How can you avoid becoming a 'medical mystery'? (advisory.com), May 2, 2022
[iii] Pepper, Leslie, 8 Ways to Help Your Doctor Make the Right Diagnosis.12/20/2011. Avoid Misdiagnosis: 8 Ways to Help Your Doctor Make the Right Diagnosis (webmd.com)