In ancient and modern times, the historical records and statistics of doctors’ errors in the process of diagnosing and treating diseases have conclusively informed people that medical errors are inevitable, and in ancient times in China there were monographs published in the “Medical Forest Correction of Errors”. This shows that doctors’ misdiagnosis and efforts to correct errors have existed since ancient times.
From 1950 to the present, domestic and international studies on misdiagnosis have shown that the rate of misdiagnosis is around 30%.
For example, among tumors, the average misdiagnosis rate of malignant tumors such as nasopharyngeal cancer, leukemia, malignant lymphoma, pancreatic cancer and colon cancer is over 40%; among tuberculosis, the average misdiagnosis rate of extrapulmonary tuberculosis such as liver tuberculosis, stomach tuberculosis, mesenteric lymphatic tuberculosis, middle ear tuberculosis and pharyngeal tuberculosis is over 40%; among infectious diseases, the average misdiagnosis rate of epidemic hemorrhagic fever, typhoid fever, paratyphoid fever, leptospirosis, schistosomiasis and leptospirosis is over 30%. Among the infectious diseases, the average misdiagnosis rate of epidemic hemorrhagic fever, typhoid fever, paratyphoid fever, leptospirosis, schistosomiasis and leptospirosis is more than 30%; among the organ ectopias, the average misdiagnosis rate of thyroid ectopias and endometriosis is more than 60%.
In a 2013 analysis in the U.S. journal Patient safety & quality healthcare, it was estimated that 210,000 – 440,000 people across the United States die from medical errors each year, making it the third leading cause of death for Americans, after cardiovascular disease and cancer. This shows the seriousness of the problem.
Our hospitals have monthly medical statistics every year, and the malpractice rate is never within 5%, which is unrealistic and misleading to the public. People have long thought that they can’t go wrong when they go to the hospital, and even if they do, it’s a rare occurrence. Of course, regardless of whether the percentage of compliance is high or low, for each specific patient there is only right and wrong, i.e., 100% and 0%. Whoever encounters an error is 100% misdiagnosed.
Consequences of misdiagnosis Once a misdiagnosis occurs, the consequences are varied and will have a negative impact on the individual patient and his or her family, the physician and hospital that caused the misdiagnosis, and society. However, misdiagnosis also has 3 different outcomes in terms of its direct effect on the patients themselves.
1. Although the misdiagnosis was made, no measures were implemented under the guidance of the wrong diagnosis, and no adverse consequences (mental and physical suffering, shortened life, death, etc.) were caused to the patient, and this misdiagnosis was ignored.
2. As a result of the misdiagnosis, the ensuing treatment is also wrong, causing adverse consequences (mental and physical suffering, shortened life, death, etc.) to the patient, but it is not noticed and the misdiagnosis is naturally submerged.
3. Misdiagnosis leads to mistreatment, which causes adverse consequences to the patient (mental and physical suffering, shortened life, disability, death, etc.) and is discovered, causing disputes and more intense conflicts.
Why does misdiagnosis occur?
1. The complexity of the human body. People eat grains and cereals, go through clothing, food, housing and transportation, take in the wind, frost, snow and rain, perform the seven emotions and six desires, experience birth, old age, sickness and death, all these are natural phenomena, which belong to objective existence and are not subject to human will. Despite the rapid development of medicine, the understanding of the mysteries of the body and the nature of disease is still far from the level of the “free kingdom”, and doctors can only treat a very limited number of diseases. It can also be said that doctors, faced with a large number of incurable diseases, can only hope to cure them.
Diseases go through a process from insidious to clear, from atypical to typical, from general to specific, from common to rare, from unknown to known. There are also many diseases in their occurrence and development from the beginning to the end are relatively insidious, atypical, and make the diagnosis difficult to clarify, so that the treatment plan is difficult to establish.
2, the practical nature of medicine. Medicine is an empirical science, with a strong practical. Any famous doctor grows up from the experience of constantly summarizing mistakes. Experienced doctors have to experience from young doctors step by step, relying on the accumulation of experience in one case. In this process, they will inevitably experience various mistakes, and the same is true for the development of medicine and the improvement of medical skills.
In fact, in the actual medical process, due to the lessons learned from a large number of medical errors, the hospital has established strict rules and regulations and preventive measures, such as the three-level examination system and the three-check seven-pair system, the vast majority of errors have been corrected or nipped in the bud, and no serious consequences have resulted. The five years of schooling for an undergraduate in medical school means that he or she just has the basic knowledge to practice medicine, and even if he or she graduates with a master’s or doctorate degree, he or she still needs to experience 5 – 10 years in the clinic. It takes enough clinical practice, personally treating a certain number of cases and dealing with a variety of different variations of conditions to grow into a mature doctor.
In fact, misdiagnosis and malpractice are objective and inevitable for anyone. Positive experiences and negative lessons have an equally important role in the development of medical science. The courage to expose clinical errors and report the occurrence of misdiagnosis and misdiagnosis can educate yourself and, more importantly, can benefit more people.
3. The individual nature of disease. The nature of many diseases is far from clear, and the performance of the same disease in different individuals varies greatly, so it is not objective to ask doctors to correctly see the essence through the phenomenon every time. Even natural phenomena such as earthquakes, floods and other natural disasters are still difficult to predict, let alone diseases that occur in such a complex and highly organic human body. Therefore, doctors are not yet able to fully control the evolution of diseases in the patient’s body.
Today, doctors can cure only a few diseases, most of which can only be treated symptomatically, and the cure is only the ideal and goal. Therefore, it is often said that the doctor treats the disease but not the life.
Our famous medical doctor Zhang Xiaoqian has a famous saying: disease is like the face of a person, no two are exactly the same. The patient’s gender, age, birthplace, upbringing, cultural level, personal cultivation, social environment, psychological quality, etc. are all different, as well as the display of disease, self-expression, individual tolerance, acceptance of treatment methods, drug sensitivity, etc. are also different. It is not too much to describe the occurrence, development and regression of diseases as “very different and rapidly changing”.
Doctors have been a revered profession since ancient times, but from the magpies and Hua Tuo to the famous doctors of today, all of them make mistakes, and there is no miracle doctor who does not make mistakes.
Due to the individual nature of the disease, the symptoms and signs of the same disease can be different in different patients, so each specific case is a process of research, analysis and prediction from scratch, and each patient has a “new” disease. What was a successful experience for the previous case may become a mistake and lesson for the next case. Therefore, doctors work every day on thin ice, such as the abyss, the slightest carelessness, will cause the consequences of a single mistake.