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Cases & Commentaries
- Web M&M
Jeanne Mandelblatt, MD, MPH; February 2004
A physician who does not accept Medicaid turns away a woman needing evaluation for 2 years of profuse vaginal bleeding. She later presents to the ED, where examination reveals invasive cervical cancer.
Olsen D. State Journal-Register. June 26, 2011.
This newspaper article discusses a case of diagnostic error, explores the complexity of the diagnostic process, and provides tips to help patients avoid such errors.
Journal Article > Study
Influence of doctor–patient conversations on behaviours of patients presenting to primary care with new or persistent symptoms: a video observation study.
Amelung D, Whitaker KL, Lennard D, et al. BMJ Qual Saf. 2019 Jul 20; [Epub ahead of print].
Despite many advances in cancer treatment, delays in cancer diagnosis cause substantial morbidity and mortality. System factors like difficulty obtaining appointments contribute to late cancer diagnoses. Timely cancer diagnosis also requires that patients and physicians communicate effectively about next steps in the workup of symptoms. This qualitative study recorded videos of patient–physician interactions and found that 31% of the time, doctors and patients did not align in their perception of the seriousness of a given symptom. The authors theorized that misalignment leads to missed follow-up testing and deterioration in patient–physician trust. A WebM&M commentary described how the cost of a diagnostic test led to a late diagnosis of colon cancer.