9 Mistakes That Can Lead to a Misdiagnosis in the ER
There were 130 million ER visits in the United States in 2013, according to the National Hospital Ambulatory Medical Care Survey. As a patient, it’s your job to provide emergency physicians with the information they need to build some groundwork for an accurate diagnosis.
You don’t give a succinct, accurate summary of your symptoms
An ER doctor doesn’t have the time to listen to all your health problems from the time you were born. They have a waiting room packed with patients and often not enough doctors to go around; don’t encourage them to rush to a potential misdiagnosis by keeping your health history short and sweet. “Patients have to understand that doctors need a simple, fairly straightforward summary of the sequence of events that happened to them,” says David Newman-Toker, MD, PhD, Director of the Division of Neuro-Visual & Vestibular Disorders at Johns Hopkins Medicine in Baltimore, Maryland. Simply tell them what brought you to the ER, and be as precise and chronological as possible in your description. Doctors confess other ways patients can screw up in the ER.
You don’t keep a health journal
The moment you start feeling unwell or experiencing unusual aches and pains, write it down. Documenting the symptom and frequency not only gives you an accurate health summary to tell the doctor, but also helps them get a clear picture so they can properly diagnose you. “Pay attention to patterns,” says Nicole Franks, MD, Chief Quality Officer at Emory University Hospital Midtown in Emory, Texas. “Often when a patient presents with a problem and there’s no clear explanation, there’s an acknowledgement that something’s going on but it may not be identified.” You can also use a fitness tracker to help keep tabs on your health.
You don’t know your medical history
Meeting an ER physician for the first time is like going on a blind date; neither of you know anything about the other, including your medical history. Make sure to alert the ER doc to any similar health experiences in the past, current health conditions (including blood sugar levels if you have diabetes or blood pressure and cholesterol numbers if you struggle with those), and relevant family health history. Giving the ER doctor a sneak peek into your medical history plays a role in helping them establish a basis for a correct diagnosis. “The best thing that you can do is be honest and forthcoming about what is going on with your health, be a good participant, and answer questions,” says Dr. Franks. “Decision-making is only as good as the information that is presented.” Cooperation and speaking up are a few other ways to help you get an accurate diagnosis.
You don’t keep a list of medications
Keep a medications list in your wallet or on your phone, and include what they are for so the doctor can gauge what kind of health issues you have and make sure they don’t prescribe anything that could interact with what you’re currently taking. “People have to realize it’s a limited time and I know nothing about you to try to deduce what’s going on,” says Dr. Franks. “Any additional records, medications, allergies, response to medications, or any past history is helpful in coming to an appropriate reasonable decision.” Here’s how to organize your medicine cabinet.
You don’t ask the right questions
It’s perfectly acceptable to politely probe the doctor about the diagnosis you’re handed. You are your own biggest health advocate, so don’t be afraid to pick the doctor’s brain for how they arrived at their conclusion. “Asking questions means something more than just asking questions in a general sense; be a bit intentionally skeptical,” says Dr. Newman-Toker. A sample of smart questions are, “Could this be something more serious? What symptoms should I look for if it is more serious? What is it about my symptoms or health situation that brought you to this diagnosis? I thought it was (insert health issue here), what do you think?” If you have a condition, research the questions you may want to ask. For example, these are the types of questions every diabetes patient should ask their doctor.
You’re afraid to ask for clarity
There’s no such thing as a dumb question when it comes to your health. It’s easy for any patient to get lost in all the medical jargon, so speak up and ask your doctor to break it down for you. “Patients should ask questions about the diagnosis,” says Gordon Schiff, MD, primary care specialist at Brigham and Women’s Hospital in Boston, Massachusetts. “You should at least make sure you’ve heard it and understand it, or [have your doctor] explain it.” Also, be straight with your doctor: There’s no point in lying to health professionals.
You don’t bring a loved one with you
A trip to the ER is anything but a walk in the park. Bring a friend or family member with you to ease your worries. Even better, a loved one may mention a symptom you forgot or ask questions you never thought to. “If you bring somebody with you to the ER that cares about you, you bring a second set of eyes and ears that can [listen and] hear,” says Stephen Anderson, MD, Director of Stroke Services and Co-Chair of South King County MultiCare Health Foundation in Auburn, Washington. “Sometimes we don’t remember what people say in times of stress.”
You don’t trust your gut
If you feel leery of your diagnosis, go with your instinct and get a second opinion. “I think patients’ instincts about whether something doesn’t add up are more often right than wrong,” says Dr. Newman-Toker. “Sometimes getting a fresh set of eyes a few days later is what makes the difference.” Your worries may be nothing more than a bad case of paranoia, but it’s better to be safe than sorry. Look out for these body cues to determine if your doctor is actively listening to you.
You don’t follow-up
As a patient, you play a big role in acting as your own safety net against medical uncertainty. When you exit the emergency room, you should follow up with your primary care physician to discuss your diagnosis or visit with a specialist if the ER doctor recommended you see one. “If you see one provider who interprets it as one way and if it continues to happen, do not be dismissive,” says Dr. Franks. “Sometimes things present a little vague and it may take some time to declare itself, so you should pay attention to those subtleties and follow up with your primary care if something still feels off.”