Accurate diagnosis prevents medical error
Major and minor health conditions can have very similar symptoms that can often appear as same and as a result confuse any doctor
Reaz Islam
Between October 1 and October 10, 2019, according to the Directorate General of Health Services (DGHS) under the Ministry of Health of Bangladesh, 3,162 more dengue cases were recorded; following 16,856 in September and 52,636 in August, the 3 months count for more than the total number of patients in any past year. What makes this even more astounding is that the total recorded cases in one month tops the total cases reported in the country from the year 2000 through 2018, which was 50,148 cases.
Even if the severity of dengue cases had started to decrease, still it would be of great concern and currently it is a major issue and need much deserved attention. Now the question is why suddenly dengue became such an epidemic in Bangladesh? There are many reasons behind it but the most important one is that it is happening because of misdiagnosis.
There have been cases where some of the doctors were unable to diagnose dengue in time leading the patients either to face severe health issues or death. Studies indicate that as many as 50% of dengue cases have been misdiagnosed worldwide. This inaccuracy can lead to an increased cost of treatment, such as unneeded hospitalization, as well as possible increased morbidity, and mortality due to volume overload and overzealous use of intravenous fluids.
A high standard of care is expected by anyone who visits a hospital, a medical care office, or a clinic. Death and lifelong disabilities can come from a misdiagnosis error which can take place in multitudes of ways like not properly diagnosing results and not being able to give the correct treatment in a timely manner. There are various reasons why misdiagnosis occur some of which are caused by human error and some are result of faulty apparatus.
Tens of thousands of conditions can possibly affect a human being yet a person seeking medical assistance expects a doctor to know and be abreast of all the types of diseases that are present and concurrently being discovered. There are many complex and advanced diseases that all the doctors are not fully aware of and only a handful of researchers have knowledge about. Due to the lack of awareness and understanding about these complex and newly discovered diseases, doctors may confuse symptoms of that mysterious disease and diagnose it as being another disease or medical condition that is not accurate. Doctors need to test thoroughly before declaring a person is diagnosed with a certain disease because there are many diseases have overlapping, and similar symptoms. Moreover, Doctors need to be on top of recent development and discovery of disease.
Major and minor health conditions can have very similar symptoms that can often appear as same and as a result confuse any doctor. Doctors tend to do no further testing if they believe that the condition is a minor one because often patients stay skeptical of doctors referring many tests and incur unnecessary charges. But in reality, that seemingly minor condition can be a manifestation of a serious problem. For example, cloudiness in the lungs may get misread as pneumonia when it can actually be lung cancer. By doing so, misdiagnosis and lack of treatment can result from the doctors negligence to order the proper test. Often time it can be too late for the patient because they might have been carrying a time sensitive critical condition.
Human error can occur even by doctors because they are just as human as anybody else. Mistakes can be done by doctors just like they are in any other profession. But, the magnitude of outcome resulting from a mistake in medical profession is material and lead to devastating results like death of an innocent person.
What can be done to avoid such errors or misdiagnosis? According to researchers from Baylor College of Medicine, doctors should allocate time to communicate effectively with patients. They should work closely with the lab personnel and radiologists to interpret complex test results or a difficult diagnosis. Share knowledge and take advice from other doctors of the healthcare systems and make sure that all the members are on the same page about a diagnosis when multiple constituents are involved. Also, encourage patients to engage in the diagnostic process and look at their own medical notes for inconsistencies. Misdiagnosis is also prevalent in Bangladesh because of many factors but mainly because of a gap in education. For example, Bangladeshs approach to oncology treatment lags behind other countries.
On top of it, most diagnostic centers or hospitals in Bangladesh are not accredited and thus do not assure any standard of quality. In the accreditation system, institutional resources are evaluated periodically to ensure the quality of services on the basis of previously accepted standards. Standards that can be minimal and thus defining the bottom level or more detailed and demanding- setting the high bar. Accreditation is not an end in itself, but rather a means to improve quality.
All the hospitals in Bangladesh should be put through the accreditation process because it will not only strengthen the healthcare delivery system but also streamline the accountability, and responsibility of the healthcare providers towards the people and . The accreditation system will have a serious positive impact on quality assurance in terms of apparatus maintenance and thus attenuate the trend of misdiagnosis in the country. There are few institutions in Bangladesh who have been accredited by world class organization likethe College of American Pathologists (CAP). Thyrocare Bangladesh Limited is the only CAP accredited diagnostic center in Bangladesh which bears assurance of the gold standard of instruments and testing equipment for diagnosis. CAP is the worlds largest association composed exclusively of pathologists certified by the American Board of pathology.
Bangladeshs healthcare system has been suffering from many shortcomings; misdiagnosis being one of the key factors. This is diverting not only the affluent, and the middle-class but also the marginalized and poverty-stricken people from bottom of the pyramid to travel cross-border to India, Thailand, Singapore, and Malaysia for medical treatment. Health is one of the most important factors for the development of a country. Accredited diagnostic and medical service providers will not only have a positive impact on the economy of Bangladesh but will also decrease the number of people traveling abroad for medical treatment.
The writer is Chairman and Founder, Thyrocare Bangladesh Limited
