Missed diagnoses are harming or killing 150,000 patients every year. How can so many avoidable mistakes be happening?

Most of us go to a doctor or hospital because we are having a problem. If a symptom is causing us a great deal of discomfort or if it does not go away after a reasonable amount of time, chances are that good that we will want a health professional to figure out what’s wrong and come up with a treatment strategy that will help us recover.

Diagnosis is one of the most fundamental skills a medical student is supposed to master and then hone as a resident and practicing physician. We assume that all those arduous years of training have prepared doctors to figure out exactly why we are having symptoms. How well do they do at this essential task?

We were shocked to learn a few years ago that the answer to this crucial question is not very well. Even worse, it is a third rail issue. Researchers hare steered clear of this controversial topic. Professors in medical schools, hospital administrators and government regulators have pretty much ignored the problem. But in 2009 David Newman-Toker, MD, PhD and his colleague Peter Pronovost, MD, PhD, blew the lid off this scandal with a groundbreaking article in the Journal of the American Medical Association titled, “Diagnostic Errors–The Next Frontier for Patient Safety.”

In this research they revealed that “an estimated 40,000 to 80,000 US hospital deaths result from misdiagnosis annually.” During a radio interview with us they subsequently confided that the number published in JAMA was probably low and a more realistic figure was more likely 100,000 hospital deaths each year from missed diagnosis.

Keep in mind that these were missed diagnoses in hospitals. What about misdiagnosis in your doctor’s office? Until a week ago we had no good idea about diagnostic errors in a primary care setting. That all changed with an article published in JAMA Internal Medicine (online, Feb. 25, 2013). Until this study there was not much information about “Diagnostic errors (missed, delayed, or wrong diagnoses)” in a family practice clinic or internist’s office. Now we know the problem is worse than we imagined.

Researchers studied two large primary care practices. Site A was a large urban Veterans Affairs facility with 35 PCPs (primary care providers). Site B was a private health care system with 34 family medicine PCPs. By tracking electronic medical records the researchers were able to identify patients who saw a primary care provider and within two weeks either had to come back to the doctor’s office or go to an emergency room or be admitted to a hospital. They then analyzed the records of such patients to see if there had been a diagnostic error.

Of the 190 cases where diagnostic errors were discovered, most “had potential for moderate to severe harm.” Here are the some of the common missed diagnoses:

  • Kidney failure
  • Pneumonia
  • Cancer
  • Cellulitis
  • Congestive heart failure
  • Compression of the spinal cord
  • Urinary tract infection
  • Adverse drug effect
  • Heart attack or severe heart problem

When such serious conditions are missed in a primary care setting they will be often be treated incorrectly and the outcome can be delayed recovery, severe complication or death.

According to an accompanying commentary by Drs. Newman-Toker and Makary, “more than 150,000 patients per year in the United States might have undergone misdiagnosis-related harm.”

Why? Why are there so many missed diagnoses? The researchers suggest that there are breakdowns in communication. Time pressure almost assuredly interferes with the process. Doctors are trained to make quick decisions based on obvious symptoms. Doing so can divert their attention from the actual cause of the problem. These researchers documented that there were serious flaws in history taking. Patients may not have gotten to tell their stories completely. And doctors did not connect the dots accurately. Moreover, doctors do not always communicate with each other well to make sure that data from tests are transmitted appropriately.

The real shocker in this study, though, was the lack of what is called a “differential diagnosis.” In 80% of the missed diagnoses, doctors failed to follow a time-honored medical practice of considering all the possibilities and prioritizing them appropriately until the correct diagnosis was reached.

Bottom Line:

Far too many patients are misdiagnosed, either in a doctor’s office or in the hospital. These mistakes lead to inappropriate treatment and that causes “serious harm, permanent damage, immediate or inevitable death.” The authors of the study call for “patient empowerment and engagement in the diagnostic process.” We couldn’t agree more.

In our book, Top Screwups Doctors Make and How to Avoid Them we have a list of questions to ask your doctor the next time you have a problem.

Top 10 Questions to Ask to Reduce Diagnostic Disasters:

  1. What are my primary concerns and symptoms?
  2. How confident are you about this diagnosis?
  3. What further tests might be helpful to improve your confidence?
  4. Will the test(s) you are proposing change the treatment plan in any way?
  5. Are there any findings or symptoms that don’t fit your diagnosis or that contradict it?
  6. What else could it be?
  7. Can you facilitate a second opinion by providing me my medical records?
  8. When should I expect to see my test results? Will you call with them, or will they come by mail or electronically?
  9. What resources can you recommend for me to learn more about my diagnosis?
  10. May I contact you by e-mail if my symptoms change or if I have an important question? If so, what is your e-mail address?

You can learn more about how to avoid diagnostic mistakes in the book. We provide details about the Top 10 Reasons Why Doctors Screw up Diagnoses and give you the tools you need to prevent this from happening to you or someone you love. You will also find out more about the most commonly missed diagnoses so you can be prepared. Here is a link to more information about the book.

Here are some stories below about the implications of such errors from real people.

This came from J.L.B.

“Several years ago my wife had a bad case of bronchitis. Our family doctor put her on an antibiotic. She felt better for a few weeks and then she started coughing severely again. We went back to the family doctor who is a great person and competent doctor. He was going to put her on another kind of antibiotic. I am an accountant and as an analytical person I asked him a sensible question which was ‘Why is my wife coughing so much after going through a round of antibiotic. Shouldn’t some more tests or x-rays be taken?’

“He thought over my statement for a minute and then ordered a chest x-ray. What the x-ray revealed was that my wife had a mild case of pneumonia. There was some fluid in the bottom of her lungs which showed up on the x-ray. The doctor then ordered her to stay in bed for several days and prescribed another antibiotic. Bed rest is mandatory for pneumonia whereas a person can be up and on their feet if they have bronchitis.

“If he had not discovered that she had pneumonia, she would have been on her feet and getting worse and worse. After that event whenever we went to the doctor he would ask me if I had any questions. He had a new respect for my observations/comments. He had almost made a wrong diagnosis which could have resulted in very serious situation for my wife.”

“This happened many years ago and somehow I survived. I was having severe stomach pains which went around to the front and I was nauseous for days. I was about 20 years old and had been having “bouts” for the past couple of years on and off but with increased frequency.

“The military doctor I went to did not order any tests because he decided that I was just lonely for my new husband who was stationed in Japan. How did he come to that conclusion? He had a daughter who was lonely for her new husband as well.

Within a few months I went overseas and got pregnant. I had a daughter and fortunately had no attacks during my pregnancy. But within 3 months of giving birth I had such an attack that I literally had to crawl on my hands and knees to get help from a neighbor.

“It turns out that I had gall stones almost the size of golf balls and was extremely lucky that I had not had an attack during my pregnancy because both my baby and I could have died.”


“My 86-year-old father went to three specialists (cardiologist, internal medicine and pulmonologist) in November complaining of shortness of breath and fatigue. All three told him he was fine. The cardiologist, who had been treating Dad for an irregular heart beat, told my sister he was concerned Dad was showing signs of dementia. The internal medicine specialist prescribed an anti-depressant.

“He collapsed 10 days after seeing the pulmonologist, 20 days after seeing the cardiologist. The emergency room team said he had pneumonia and was almost at end stage congestive heart failure. He also had pneumonia. He died 10 days later.

“I wrote the doctors two weeks ago asking what tests they performed to determine he was fine. Haven’t heard back and am guessing I won’t.”


The stories above reinforce the research just published in JAMA Internal Medicine. Pneumonia and heart failure are frequently misdiagnosed. Don’t let it happen to those you care about. Be assertive! Ask about the “differential diagnosis” and make sure the doctor tells you what else might be causing your symptoms (besides the “obvious”).

We do not want you to become a statistic. Missed diagnosis is one of the more common causes of death in America, right up there with strokes and adverse drug reactions. It shouldn’t be. These are preventable errors. We hope you find our book helpful in avoiding medical mistakes.

Share your story below. We hope it will empower other patients so that they can take more control over their health.

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  1. Bill
    Qld. Australia

    I have had a number of diagnostic throughout my life. The most recent was when I felt unwell for several days and suddenly became seriously weak and had trouble breathing. Taken to hospital and told I needed to be admitted. In hospital for over a week, coughing up just blood. The doctor in charge kept coming to my bed clasping his hands and saying “that didn’t seem to work mate, we had better try something else”. After over 10 days of this two nurses pressured a relieving doctor to transfer me to a large city hospital where they confirmed a diagnosis of Pneumonia. When I was in ED I heard two doctors chatting. One said the other “He’s don’t nothing right”. Fortunately I was in good hands and after a total of just about 5 weeks I did leave the hospital, very weak and tired after huge doses of Prednisone, which caused me to have to start Insulin. On speaking to the doctor after discharge I was told ” I had doubts of you ever recovering. Now 15 months later I am still very weak and having trouble with controlling Diabetes.

    One of my earliest problems arose when I was about mid forties. I went to my family doctor many time complaining about being tired and weak with breathing problems. This was after having acquired Thrombosis from an injury while working when a doctor froze an area of pain, to prove that I was malingering. The family doctor kept doing Cardiograms while I lay on my back in his surgery. He always came back with “There’s nothing wrong with you”, so I went to a gym to see if I could improve my fitness . They did a stress test and said I had a strange result with my heart, but they were not able to diagnose the problem but I should see my GP and seek his advice. Went back to the GP, with the same outcome as before. I insisted on a referral to a specialist and was asked who would you like to see. Finally I saw a pathology chap who passed me on to a large city hospital, where it was found that I was in urgent need of CABGs (3 grafts). I never went back to him after that, but he saw my wife in the street one day and said “who would have thought of that” when told of what had happened.

    Sixteen years later, in another medical practice, I went through the same experience once more when I was told forget it, there is nothing wrong. Again I insisted and was found to be in urgent need of four Bypasses.

    One other major problem was when a GP told me that I should stop worrying about what was wrong with me and just enjoy my life. This was when when a specialist reported that I had nothing wrong with me, but I was severely depressed and prescribed heavy Psychotic drugs for me. I told him that he had no idea of what he was talking about and booked myself out of the hospital that he wanted me in for tests. I went to a large city hospital again and it was found that I had bad Asthma, Complex Apneas and Pulmonary embolisms. Why am I still alive at almost 81, with CAD, AF, Bundled Branch block, COPD, severe pain from Spinal problems with my entire spine, as well as long ago diagnosis of CFS and Fibromyalgia to state a few. Oh I had a Stroke following my first round of CABGs. I have had similar problems finding a decent mechanic. I have ben able to work all my life and even studied and became a teacher after my stroke made it impossible to continue working in industry due to safety concerns. I now have Glaucoma as well because several specialists never advised me that I should start treatment when my pressures rose to 30. There is more, but I am sure that you may have heard enough. Don’t forget if you have a problem, see your doctor and then get another opinion or more.

  2. Denise T

    My 60-year-old husband, who had never been constipated in his life, saw his GP when he suddenly became constipated for three days. Because he mentioned that he’d been feeling a bit lethargic and depressed, the doctor reassured him and recommended increased dietary fiber, exercise and an antidepressant if his mood did not improve. Three days later I took him to his gastroenterologist who ordered an immediate ultrasound. This led to more tests and within two weeks my husband was diagnosed with stage IV lymphoma! There was a tumor pressing on his duodenum, making it too narrow for normal digestion. He is undergoing chemotherapy and hoping for a good outcome. I learned two things from this experience. First, take the advice very seriously to see your doctor if you have a change in bowel habits! Second, if you have any doubt about a diagnosis, seek a second opinion immediately. You may have to insist that the doctor’s office “work you in,” but waiting weeks for an appointment can make a bad situation far worse.

  3. Mia

    I am currently recovering from a broken foot. I was told I had a ‘Jones Fracture’. I asked 4 separate visits to see my xrays ( I was told each time the doctor “couldn’t access them”); and never did see them. I like to know about my health issues. I researched this fracture and became very concerned regarding the high rate of ‘non union’ for this type. I printed out diagrams showing the exact location of the fracture type, and info regarding the suggested protocals for treatment (from medical journal studies on early weight bearing vs a period of longer non weight bearing etc). I was well informed from reliable sources. From the start I was concerned at the lack of communication; from how to use the walking cast; to how and when to progressively weight bear.
    I expressed my concerns regarding the xray results that just kept coming back reporting minimal signs of healing. I expressed my fear of the fracture delay in healing and what I had read about the high rates of non union in Jones Fractures. I had pain all along as well, and given the xray reports, I feared that it could be due to the un-united fracture and improper weight bearing too early on. I developed eczema from stress , and I was very worried at this point. At week 9; I reported I still had pain; we did another xray; the results still showed an un-united fracture with little signs of healing response. At this stage my doctor consulted a specialist. The ortho surgeon reviewed my xrays. At my doctors visit to discuss the results the doctor said the specialist suggested a CT scan. The doctor let it be known that he felt I was “over-analysing” and overreacting. He said “it’s not like you have cancer”.
    I asked for copies of my radiology reports and the report from the specialist. He said they were unavailable. I insisted I expected a copy. He then turned on his computer and printed them out. I read the specialist’s report when I got home. It said that the xrays did not support the diagnosis of a Jones fracture. It also stated that the type of fracture I did have would not show the expected healing signs that other fractures did because it was a callus bone area and healed from the inside out instead of outside in as other fractures do. I was so relieved! It was not the dreaded high risk fracture after all! And there was the explanation for the xray reports. Explanations that provided clear, well explained answers to my progress. I also was very disconcerted that the doctor had not told me any of this, especially as I had so often expressed my concerns in regards to the problems related to that type of high risk fracture.
    He did not tell me it was not a Jone’s fracture; nor did he explain why the xrays were consistently showing no healing. My fears about all of this had influenced my interpretation of the pain I experienced, as well as my frame of mind and my feelings about where my progress was going given my xray reports. It did cause me a lot of distress. Now I do not expect doctors to be infallible; they are very bust people with a demanding and difficult job. Dealing with the demands of ‘the public’ is not easy either. But I still remain disconcerted; and I feel that this incident has tainted my relationship with my primary care giver. What do I do? Why did he indicate to me that I was overreacting? Why didn’t he treat me with more respect?

  4. Jo S.

    I went to the doctor with two complaints: I had sharp pain in my left shoulder and I was gaining weight even though my diet and exercise level had not changed. They ignored the weight gain and focused on the shoulder for over a year. I was sent to a variety of specialists all of whom could find nothing wrong with the shoulder. Eventually one specialists pressed on my abdomen. I was scheduled for surgery within a week and had 5 separate tumors removed. Following the surgery the pain in my shoulder was gone. Thankfully the tumors were all per-cancerous, but if any of the doctors had paid any attention to my weight gain complaint the tumors would have been found much earlier.

  5. DGuidry

    In 1978, when I was 17 years old, I thought I had the flu. The entire night I vomited every 15 minutes to the point that I was dry heaving by morning.
    My father was a medic in the Navy and was also pre-med advisor at the University where he taught Chemistry. He determined that I probably had appendicitis and took me to the ER.
    When the resident on call finally saw me, he decided without doing any tests that I had gonorrhea and not appendicitis because my pain wasn’t in the lower right quadrant on my abdomen (he also probably decided that because of my age). When my father told him that he was sure that I had appendicitis the resident responded with “Now who’s the doctor here”, and then blew my father off and proceeded to get me ready for discharge.
    It was a good thing that my parents were personal friends with the Chief of Staff of the hospital (they called him at home to get me admitted) because my “gonorrhea” ended up being peritonitis due to a ruptured appendix, which put me in ICU for 10 days, where at one point they weren’t even sure if I was going to survive.
    I’m sure that our family friend informed the resident that the appendix is not necessarily in the lower right quadrant and that he was damn lucky that he wasn’t sued for malpractice.

  6. Neil K.

    In April of ’93, while working as a foreman in a cemetery, I stooped down and pried a sheet of plywood from the ground to which the plywood had frozen. I immediately felt a tearing and sharp pain in the left side of my groin. I continued working and later, while using a backhoe to dig a grave, the vibrations from the diesel engine of the backhoe made the pain in my groin excruciating. I went to the medical center that my HMO insisted I use. There, a PA said that I had testicular torsion. Having known people who had hernias, I asked if it could be a hernia. His response was no. The pain continued for weeks and during a return trip to the medical center an MD said that I had epididemitis (unsure of spelling). I asked if it could be a hernia. He said no. He began giving me some antibiotics which did nothing and the pain continued to get worse.
    After a few more months of this I went to a urologist and told him what had happened. He examined me for a hernia. He said that he isn’t too familiar with hernias but everything felt normal. The HMO allowed me to switch to another medical center where they diagnosed a double hernia.
    I had a double hernia repair in Dec. ’93, seven months after the hernia. Prior to the surgery the pain had reached a point that, I would hurt only after a very physically demanding workday. Since the surgery I have hurt constantly. Repeat trips to the new medical center resulted in being told that the new pain was caused by adhesions and I should learn to live with it.
    Prior to the surgery I hurt sometimes. After the surgery I hurt all the time and the pain was more intense and sharper. Now, almost 20 years since the surgery, the pain is about a four. I guess I just got used to it.
    From now on, if I question a Dr. and he says “I’m the Dr.” my response is “Even the last graduate from every graduating class at every medical school is still called Dr.” At that point I get copies of my clinical file and find another Dr.

  7. EBA

    My story goes way back to the late 80’s and early 90’s. Went to the doctor because I had a very localized pain on my right side (not in the abdomen) especially if I tried sleeping on that side. He sent me to an “arthritis specialist” whom I learn years later wasn’t one, just an internist with an special interest in arthritis. He examined me and prescribed Desipramine 10mg or 20mg if you need more. Usually it is given at 100 to 150mg for depression he told me. He said the low dose of 10mg sometimes help people with complaint like mine.
    Unknown to me he diagnosed me as having fibromyalgia. I only learned that from looking at my medical records years late. I began taking this and sometimes I thought, well maybe it was helping and other times not. But it was such a low dose and such a small pill, I thought what can it hurt? Boy was that a bad idea.
    A year later I started having a rapid heart beat and went back to my regular, original doc. Without any investigation as to why he put me on a beta block called Proprananol. Heart rate came down but then stopped helping so was switched to digoxin! Still no explanation or investigation of heart and still had original pain in my side. Kept taking these meds out of ignorance. Then I began having strange shaped bowel movements. Went back to original doc to report this. He ordered a barium enema, which in hindsight I believe did even more damage to the bowel.
    Went to a physiatrist who wanted to prescribe exercises for my back but when he saw I was on Digoxin wanted an ok from my cardiologist. I said I had never seen one. You guessed it, next doc was cardiologist. Had me wear a Holter monitor and pronounced my heart as fine. Told me I needed to exercise more! Then he said you are taking Desiprmine and sometimes that can cause a rapid heart beat but you are taking such a low does it shouldn’t matter. Didn’t say to stop it but I went home and thought about what he said and started to wean myself off of it.
    My heart rate came down and then weaned myself off the Digoxin. My bowel movements had stayed the same, weird shapes. Told original doctor who said you need to see a gastroenterologist. This is doc #4. “you need more fiber.” Started on fiber regime which did nothing except make the oddly shaped stool (both a vertical axix and a horizontal). Went back to say it was not helping and he said you just need to take more. When I increased the fiber dose it made the stool even larger and just as oddly shaped.
    Then I became my own medical detective. The first med Desipramine wasn’t metabolized by me and became toxic to my system and got piled up in my system causing the rapid heart beat. Then the beta blocker and later digoxin were all working on my autonomic nervous system One was telling it to speed up while the other was telling it to slow down and my bowel got pulled into this cycle of both, speed up and slow down and in the process got permanently damaged. My heart rate years later is still normal but the bowel seems to be forever damaged with passing very small pieces of oddly shaped stool. Many bowl movements a day (not diarrhea). Had one bout of divirticulitis but take a mod dose of fiber to prevent more.
    And oh, by the way, I still have pain on my right side. It was finally diagnosed correctly as bursitis as the result of a fall from my bike a year or so after I began to complain about it. Had some cortisone injections but the thing that helps most is using a foam topper on my mattress. What a nightmare it all was and can you even imagine the cost? I am still dealing with docs about this and can seem to get no help. They also don’t seem to believe my story.

  8. G.P.G

    I am in the year in which I will turn seventy. I remember the time when doctors could be trusted. But ten years ago I started seeing various “providers” (what a horrid word!) in the clinic in our nearest town, and with the same complaint. It was disabling pain from my sacrum all the way around my hip and down the front and side of my leg, making it harder and harder to walk or sleep and, on top of that, to work.
    Finally with pain spreading to between my shoulder blades I went off work and continued my quest for answers. Finally in frustration I asked the NP who was seeing me that day to just refer me to the pain clinic. At that first appointment I was told the problem was “from my spine.” Interestingly my spine did not hurt. I saw the MD connected with the pain clinic and he provided me with one steroid injection in the area of my knee which had searing ripping pain in it. He did nothing else except for watch while I dragged into and out of his room and obviously I quit going to see him too.
    It got quite tiresome to see, every time I went there for an appointment, other people dragging themselves painfully across the parking lot, to the doors, and then dragging themselves back out again to their vehicles in the parking lot. I had an idea that not all was well here. Spooky. Watching old people get older and older, and more and more feeble.
    But it was not until two years after that, just before my disability policy was to quit paying because they only go for two years unless you have one of two exclusions, that at the advice of a friend I saw a chiropractor who, after reading over my new patient introduction paperwork, had a weight-bearing standing x-ray taken and there was my scoliosis. Pretty fabulous and providential too was the shock that one of the two exclusions for my disability policy was scoliosis.
    Absolutely fascinating to me that these maligned men and women of chiropractic have more knowledge and understanding of the human body than the MD’s. Pitiful in the unspeakable extreme. It is also pitiful that I had to search on my own at the library for answers to my pain, and I found in the AARP magazine that the relentless pain across my backside was my piriformis muscle in constant contraction. Step by step I found out about my condition without the help of a single MD and I found out how to help myself too.
    This was not a misdiagnosis so much as a failure to diagnose, and a failure to take the simple x-ray that would have shown us my spine! I have continued my search for answers, and I have been on a long and fruitful search.
    The recent program with Dr. Sinatra the “New Cardiologist” has opened up a further step for me as I bought one of his books and read about the supplements he recommends because on your program with him I did not get them all straight.
    I am very thankful for having hearad that program because it sent me right to the supplement place for D-Ribose and Co Q10 among other things, and my stamina has already improved, as well as the muscle atrophy, the crawly feeling and pain in my muscles is well gone, and I will now be able to exercise and get some reasonable strength back because my muscles now have the supplied fuel they lack of which was killiing them fiber by fiber and day by day.
    May I say the MDs are indispensible if you get hit by an SUV or fall off the silo! And other items like that! But for daily life? Look somewhere else.

  9. RLB

    I read all of these comments and am not surprised by any of them. After my near death experience with misdiagnosed appendicitis, I was fortunate to find a doctor who really listens. I have taken control of my health care with his cooperation and support. It really works! In some defense of doctors, they are tied to medical protocols. Certain symptoms, certain protocol. As long as the protocol is adhered to, there is a defense against errors even though the misdiagnosis results in the use of an inappropriate protocol.

  10. Wayne

    I was misdiagnosed or not diagnosed with Hypothyroidism for 3 years? I have COPD, moderate, use Oxygen and nebulizer. I am on a thyroid med and used KELP Caps in addition to the meds and got it down to .7. The M.D. was furious when I told him and his meds needed updating.

  11. PP

    A friend died last week of cancer. She had been treated for some time for “Sciatica.” Turns out it was cancer in pressing on the sciatic nerve. They didn’t find that out until there were symptoms in other parts of her body that were the secondary cancers.

  12. Oldetimer

    Several years ago, my wife got food poisoning (never proven, but obvious) in a restaurant. She vomited in the lady’s room and I immediately took her home. She had a history of “never” being sick, so she stayed at home for two days, but got worse, and became totally incontinent.
    I took her to her PCP who advised me to take her to the emergency room at the hospital. Then we waited over seven hours for someone to see her which include several hours even after triage. While in the ER she appeared to be in no distress. When she was admitted to the ER they told me they wanted to keep her overnight.
    They next day they showed great concern and admitted her to the Intensive Care Unit. They had discovered she had Pulmonary Fibrosis. They then began “heroic” treatment trying to save her life. She was hooked up to several tubes for IV feeding, and for other reasons, and was received very heavy doses of steroids. I was called into a conference and asked if she had a Living Will. Finally, the attending pulmonologist strongly suggested (if not demanded) that she be weaned off the steroids.
    As soon as that started, she began to recover. Apparently, the ICU doctors were so concerned about the pulmonary fibrosis they overlooked the Aspiration Pneumonia she developed as a result of the various, unidentifiable germs that entered her lungs when she vomited.
    The pulmonary fibrosis had been in remission for decades and was asymptomatic. For several reasons we did not seek or take any legal action. She and her pulmonologist have been in a “mutual admiration society” ever since.
    Dear Oldetimer,
    Thanks so much for sharing this amazing story. It is a classic case of “anchoring” as describe by Dr. Jerome Groopman of Harvard. Once doctors throw their anchor down on a diagnosis they have a hard time dislodging it. That is to say, a snap decision can have devastating consequences. It is always essential to ask about the “differential diagnosis.” What else could be causing the problem?
    Thank goodness the pulmonologist figured this out and saved the day! We hate to imagine what might have happened if he had not intervened.

  13. Philip M.

    In December 2000, I had severe stomach cramps.My internist diagnosed diverticulitis and prescribed antibiotics. The cramps subsided but I then developed a general feeling of malaise: fatigue night sweats shivering severe low back pain hearing loss loss of appetite. I lost about 50 lbs. in 5 months. I went to several internists who could not diagnose what was causing these symptoms. One doctor even told me “it was all in my head” and sent me to a psychotherapist.
    Since I had lost 50 lbs, he also sent me to a gastroenterologist who performed a colonscopy which was normal. I did not even have polyps but the gastroenterologist said after he listened to my heart that I must see a cardiologist immediately. I told him I was diagnosed with a heart murmur many years before but he said he thought I had some thing more serious than a heart murmur.
    I immediately went to a cardioligist who did a complete cardiac work up and concluded I probably had endocarditis which is a bacterial infection of the heart. He sent me for blood tests which confirmed I was infected by a “nutritionally deficient strep” bacteria. I was hospitalized and put on IV antibiotics but it was too late.Tests showed my aortic heart valve had been infected beyond repair by the strep so I underwent open heart surgery to replace my aortic heart valve with a St. Jude mechanical valve on May 19, 2001.
    If I had been correctly diagnosed in December 2000 or soon after, I was told I would have been successfully treated with IV antibiotics and would have never needed to undergo open heart surgery to replace my aortic heart valve. I must take coumadin for the rest of my life.

  14. Judy Z

    I recently dumped a internist who would not listen. I had severe watery diarrhea for weeks. He said keep a food diary and take immodium.
    I insisted on a gastroenterolotist but the 1st appt was in two months! I became very weak, could not leave the house for fear of an accident, and finally told him to help me or I would go to the ER.
    After a flexible sigmnoidoscopy, the diagnosis of lymphocytic colitis was made & I was told to take Pepto-Bismol. That made diarrhea alternate with constipation.
    The only thing that helped was to find the website for patients of microscopic colitis and it was there I found the right drug, insisted on a prescription and it worked! I lost 32 pounds and two months of my life.
    A proper diagnosis can’t be made if the doctor will not listen to the patient!

  15. PJM

    We too, do not subscribe to the “trust me I’m a Doctor” mantra. Both my husband and myself have been misdiagnosed and both were within hours of death because of this. Fortunately for both of us God decided we needed a little bit longer here and we both survived.
    Naturopathic and Homeopathic treatment saved the day for me and our sheer bull headedness and asking questions and requesting another opinion, as well as a lot of support and prayer from friends and family saved the day for my husband (and me!).
    We are both at present under the same Cardiologist who despises our use of the internet for information re ALL things to do with our health, but after our last visit when my husband described some of our medical misadventures, we think he found a grudging respect for our stance. We also won’t just accept medication without query and much to his consternation, have refused some altogether.

  16. jnae49

    For 7 years I was treated for asthma with increasingly stronger medications and inhalants, including a nebulizer 3-4 times a day, also with little effect. I was under the care of a internist as my primary care during this time, as well as a rheumatologist who oversaw my treatment for lupus and sjogren’s syndrome. This all started in 2000 with a stress test that I was unable to complete due to the fact I couldn’t get enough air into my lungs.
    5 years ago I was finally on oxygen 24/7 and my lungs were still failing. After hospitalization and a lung biopsy the surgeon reported that I had extensive interstitial lung disease. My particular type of lung disease is a rare complication of the sjogren’s sydrome, but the symptoms are the same as other forms. I was referred to a pulmonologist for pulmonary function tests. In one test, he deteremined that I did NOT have asthma but would now require an inhaler to help my lungs due to the damage.
    After another mis-diagnosis by the same doctor (totally different type of incident, but still, wrong dx) I have begun treatment with a new internist who LISTENS to me! Patients need to be active participants in their treatment and I think I’ve found a physician who is going to partner with me in my treatment program.

  17. Nancy M

    Many years ago I discovered I was pregnant after using a home pregnancy test. I had an appointment to see the ob/gyn for the first time on a Monday, but Sunday evening I had severe pain and went to the hospital emergency room. Once I was there I started bleeding. The doctor never bothered to come to the hospital but told them to send me home and he would see me in his office the next day for a “threatened miscarriage.” I refused to leave (I couldn’t have walked if I tried because of the pain) and after laying in the emergency room for several hours, my blood pressure plummeted and it was then they correctly diagnosed that I was hemorrhaging from an ectopic pregnancy. I still shudder when I think of the consequences had I left the hospital and gone home.

  18. RLB

    Three years ago, I began having a pain in the lower right side of my stomach. It got progressively worse so I went to my doctor. My regular wasn’t there, so I saw another doctor. He prescribed the routine blood tests, prescribed antibiotics for diverticulitis and sent me home. After a week, I was worse. I went back to the office to check my blood pressure results and he had not even looked at them.
    My regular doctor was there and immediately sent me for a CAT scan. The results came back two days later. He called me at home and checked me into the hospital for emergency surgery. I had an appendix that was on the verge of rupture. Nuff said about medical diagnoses.
    This is not an isolated case. All the old tried and true procedures are being violated and the computers which do not diagnose but only report to a human who is supposed to use the data to diagnose the illness. Doctor’s brains are being replaced by computers.

  19. RWP

    My 77 year old husband lost 20 pounds in six months. His internist said “Either you are eating less or something is eating you.” All blood work that was routinely done each year was normal. The doctor didn’t order any other tests. Ivan’s appetite hadn’t diminished. Only at Ivan’s request did the primary physician do another test, a chest Xray that was normal. The doctor had no other suggestions for his patient of over 20 years.
    Ivan had been seeing a neurosurgeon for back pain and a more and more stooped posture. The neurosurgeon finally after a couple years of trying steroid injections and physical therapy said there was no more he could do. He offered no referrals or other ideas. Finally, after many months of requests for help, the internist referred Ivan to a neurologist. He was given a number of tests and told to come back in six weeks. (All appointments seem to be about six weeks out.) Ivan was becoming weak, having trouble eating, sleeping and his posture was noticeably stooped so his slip in sunglasses wouldn’t stay on and his neck got stiff from trying to look ahead as he walked.
    We were planning an out of state trip and I was worried about traveling with Ivan because his disability was progressing so fast. After much pleading, we finally saw another neurologist from the clinic who told us Ivan had a rapidly progressing form of Bulbar ALS. What a blow. We were not able to get into a special support group for ALS patients and families because it was full. Another one would begin in a couple months. We did take the very difficult yet worthwhile trip to visit Ivan’s brothers. Our daughters visited for a week after we returned. We had engaged home hospice but used it very little. Ivan died at home of respiratory failure five weeks after his diagnosis.
    We thought the progressive weakness and possibly some of the weight loss over a few years was perhaps just part of aging. Ivan’s primary physician knew that Ivan had always been a very vigorous man, he had biked to work and after retirement he biked to the library or to meet friends for lunch. He took care of the yard and snow. He read voraciously and enjoyed music. I thought he would live to be 90 at least. I do believe that we could have had the diagnosis sooner if the physicians has been more interested and astute. Would we have wanted to know? It might have been easier for me if we could have done more planning but over all, perhaps it was just as well we didn’t have to stew about it.

  20. MO

    Yes so much that has been said is true. I’ve had a problem with doctors for years. I hate being my own doctor. You’re sick and you get no satisfaction. I’ve been diagnosed with lupus. When my test are taken, it might come back as positive and the next time it will be negative. Do they know what they are doing?

  21. Karin P

    Though it won’t kill you, orthopedic mis-diagnosis can make your life not worth living. The scariest part about orthopedic mis-diagnosis is the very real and serious conflict of interest which profits the orthopedic specialist who, having mis-diagnosed a condition, will then either offer surgery or permanent medication as a “solution.” Worst, many times the surgery won’t resolve the pain — and/or your doctor may not tell you that the pain medication they just put you on is addictive. Quality of life is horribly compromised in many cases of orthopedic mis-diagnosis.
    Had I followed the recommendations of one of the leading back specialty clinics in the country, I would have allowed them to fuse my lower back …. for what turned out to be a compressed hip joint.

  22. Shirley H.

    I too was misdiagnosed for five years and it nearly cost me my life. I was finally informed that I had Parkinson’s disease, and sent to a neurologists. During my second neurological exam, I was questioned if I had ever had a thyroid test. I did not even know what that was, or how they did the test: a simple blood test, which I had never received in my entire life, would have found that I suffered with a Hyperactive thyroid which was out of control and all my internal organs were seriously affected.
    The endocrinologists called in consultants on my case. All agreed that it was a miracle I was still alive and they had never seen a case as severe as mine. I was bouncing off the sky. I nearly died of organ failure. My heart was racing at 180 beats a minute, and no one detected it. My all over severe shaking was visible, I could not sign my name, and they had a hard time doing scans because I had difficulty keeping still.
    My health experience was a nightmare. This misdiagnosis was determined by a PA in my doctor’s office who swore that she was absolutely sure I had Parkinson’s disease. I was terrified at the diagnosis.
    I learned to research and take control of my health by questioning everything and everyone and to this day I refuse to see a PA no matter how good they are.

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