Variability in Medical Diagnoses – My Recent Adventure

I have been thinking about variability in medical diagnoses a lot this past week. I had an initially unfavorable diagnosis regarding a relatively minor issue. I was going to proceed with the recommended treatment, but fortunately, I asked an MD friend his thoughts. He said to get a second opinion and recommended whom I should use. I am glad that I followed his advice.

My second opinion came from the founder of this medical discipline – a doctor regarded as the best in the world. In an instant my diagnosis went from not fine to fine. From needing treatment to not needing treatment.

The doctor who made the initial diagnoses reportedly brought five of her colleagues into the mix in response to this new diagnosis (a highly irregular action according to my friend recommending that I get the second opinion), and they all said I was not fine. I told the world-renowned expert this, and he checked the data again, brought in a colleague of his, and they stand by the diagnosis that I am fine and no further action is needed.

I am choosing to listen to the world expert and his colleague and believe that I am fine. But what the heck? How can there be such diametrically opposed opinions?

I went to the medical literature and found that in the case of my issue, diagnoses between physicians vary 26 percent of the time. That made me wonder if that is a statistic that extends beyond my now non-issue. Given the number of medical specialties, it would be hard to figure out a general rule of diagnosis variability, so I polled a few trusted medical friends. This is what I learned:

1. Medical doctors are human and are evaluating human conditions, leaving room for variability in diagnoses.
2. Medicine is constantly shifting and evolving, affecting diagnoses or the inability to diagnose and treat with certainty in some cases. Black and white 100 percent correct determinations are sometimes not possible.
3. When in doubt, trust expertise.
4. When still in doubt, get a third opinion.

I chose to stop at the second opinion. The world expert has the expertise. In addition, I listened to my gut. I liked this doctor. He was timely, responsive, kind, and patient. Given his workload, I was amazed that he would even have time to talk with me and he did. His staff was as wonderful as he was. This is in stark contrast to what I experienced prior to finding him.

I like to think that I am relatively on the ball when seeking health, but I wouldn’t have had a clue to seek a second opinion. I didn’t know there could be such disagreement between qualified professionals on this issue. Luckily I don’t opt into western medicine too often thanks to good health, but when I do I want to at least have some sort of paradigm for success.

The four points I listed above become even more important when reflecting on past experiences trying to help family members in dire medical situations. Some doctors are not up to speed on the latest studies affecting their patients. I provided Pubmed information in hopes of encouraging better outcomes. A couple of great doctors not treating my relatives confirmed that I was on the right track in these cases. Unfortunately, even some specialists don’t stay up to speed so you have to be ready to seek further advice when you have any doubts.

Here is the biggest conundrum of all. What do you do when you don’t even know that you should doubt a recommendation or diagnosis and seek a second opinion? First, all you can do is your best. Second, try to build a critical thinking medical team. I have been fortunate to know some amazing doctors who have taught me very important lessons. Some of the docs are consistently in my life and I circle back to others sporadically. I didn’t intend to cultivate relationships with these remarkable people, but somehow I did. When I reflect on the generosity they have shown me, I am overwhelmed with gratitude. 

Comments

[Jenna]

I can relate to most everyone’s posts, finding a good doctor in the Detroit area is not easy. I recommend Dr. Pauleena Singh because she was one of the most pleasant doctors I have ever encountered. Call her (248) 792-3690 or check out her website at www.bloomfieldhillsfamilydoctor.com