Opinion!
The Mayo Clinic, based in Rochester, Minnesota, is a well-known non-profit medical practice and research group, employing over four thousand physicians and over fifty thousand allied healthcare personnel. One of the premier institutions in the world of its kind, it attracts many patients who come to Mayo for a second opinion or the confirmation of a diagnosis made elsewhere of a complex condition. Sometimes other doctors send them to Mayo for a consult; at other times, patients themselves demand another opinion.
James Naessens and his team of healthcare policy researchers at Mayo recently did a study on this that was published in the Journal of Evaluation in Clinical Practice: “Extent of Diagnostic Agreement among Medical Referrals.”
They examined the records of 286 patients referred by their primary care providers to Mayo Clinic’s Internal Medicine Division in Rochester between Jan 1, 2009 and Dec 31, 2010.
Apparently, 88 percent of these patients who come to Mayo for a second opinion returned home with a new or refined diagnosis! Or, in other words, only 12 percent received confirmatory diagnoses at Mayo. In 21 percent of cases, the diagnosis was completely changed; 67 percent received a refined or redefined diagnosis.
Said Naessens:
Effective and efficient treatment depends on the right diagnosis. Knowing that more than 1 out of every 5 referral patients may be completely [and] incorrectly diagnosed is troubling—not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all.”
Whether this is something to do with Mayo or not, I don’t know. And were the second diagnoses accurate? It would have been interesting to see if anyone got a third opinion elsewhere and how different that diagnosis was from the first two.
But in any case, assuming Mayo’s second opinion was accurate, this is kinda stunning! 88 percent of original diagnoses overturned! Hopefully Mayo’s physicians were correct and patients and their families were well served by the effort.
If health insurers limit access to care outside their networks, thus precluding secondary referrals as they are want to do, these findings could be a problem.
Naessens was worried:
This may prevent identification of diagnostic error, and could lead treatment delays, complications leading to more costly treatments, or even patient harm or death. We want to encourage second opinions when the provider is not certain.”
In a Harvard Medical Practice Study from several years ago, diagnostic error accounted for 17 percent of preventable errors in patients who were hospitalized.
Declared 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. Without a dedicated focus on improving diagnosis, these errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity.”
Misdiagnosis of complex conditions could be a major issue, causing treatment delays and complications, all leading to increased costs.
Everyone makes mistakes. And no one is perfect, but One.
Great is our Lord and abundant in strength; His understanding is infinite.
Psalm 147:5
And he is the Final Judge who makes impeccable and flawless decisions. No second opinons. No refining of diagnoses. No Mayo clinic to appeal to. Or another higher court.
God is the Judge.
Psalm 75:7
But for those who have placed their trust in Jesus Christ as their only God and Savior from sin, there will be no judgment for sin.
Therefore there is now no condemnation for those who are in Christ Jesus.
Romans 8:1
No need for another opinion!
Abe Kuruvilla is the Carl E. Bates Professor of Christian Preaching at The Southern Baptist Theological Seminary (Louisville, KY), and a dermatologist in private practice. His passion is to explore, explain, and exemplify preaching.