Do I Need A Second Opinion?
A study published in the Journal of Evaluation in Clinical Practice on April 4, 2017, found that more than 20 percent of patients are misdiagnosed. The study titled “Extent of Diagnostic Agreement Among Medical Referrals” looked at the diagnosis originally given to patients and compared that to the diagnosis later given upon the patient seeking a second opinion.
The study reviewed the records of 286 patients who were referred by their primary care doctor to the Mayo Clinic’s General Internal Medicine Division in Rochester, Minn., over a two-year period from Jan. 1, 2009 to Dec. 31, 2010.
Overall, the results showed only 12 percent of those seeking a second opinion at the Mayo Clinic had their diagnoses confirmed. However, 21 percent of the patients had their diagnosis completely changed, while 66 percent of those patients received a refined or redefined diagnosis. Overall, the study showed that almost 88 percent of patients seeking a second opinion at the Mayo Clinic receive a new or refined diagnosis.
Previous research cited in the new study showed that errors in diagnosis “…contribute to approximately 10 percent of patient deaths.” Additionally they “…account for 6 to 17 percent of adverse events in hospitals.”
“Effective and efficient treatment depends on the right diagnosis,” said study co-author James Naessens, a health care policy researcher at the Mayo Clinic, in an April 4th press release in Science Daily. “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.”
In a Washington Post article, Mark L. Graber, a senior fellow at the research institute RTI International and founder of the Society to Improve Diagnosis in Medicine, who was not involved with the study noted, “Diagnosis is extremely hard. There are 10,000 diseases and only 200 to 300 symptoms.” He added, “Doctors are humans, and they make the same cognitive mistakes we all make. If you are given a serious diagnosis, or you’re not responding the way you should [to medication], a second opinion is a very good idea. Fresh eyes catch mistakes.”
Second opinions are still encouraged, but the concern is that they may be limited due to in-network insurance issues preventing patients from seeking second opinions. In response to the problem of diagnosis error, the National Academy of Medicine has called for dedicated federal funding for improved diagnostic processes and error reduction.
It is obvious that there is an increase in cost both in diagnosis and medical treatment if the first diagnosis is not confirmed by the second opinion. However, Naessens sums up the concerns if a second opinion is not sought saying, “Total diagnostic costs for cases resulting in a different final diagnosis were significantly higher than those for confirmed or refined diagnoses, but the alternative could be deadly.”
If you or anyone you know could benefit from a better functioning nervous system, please call us at 512-452-2525 to schedule a consultation with Dr. Swanson. Austin chiropractor located in north central Austin, TX.
Pain plays a key role in the abilities of a senior to function normally. According to a 
The study reported that between 12.6 to 27 per 100,000 people suffer from TN. The problem is more common in woman and is less common in people under the the age of 40 years of age, with the average age of a person at onset being near 60 years old. The pain from TN is often severe and debilitating, often creating a significant change in the life of someone suffering from this problem. Because of this, unemployment rates of people suffering with TN is 34%.
The study begins by pointing out that as delivery is closer, the ideal position for a fetus is called vertex. This is where the fetus has the head downward with the back of the head facing forward. A breech presentation is when the buttock is positioned to exit the vaginal canal before the head. A breech birth can create a number of issues including problems with dilation and compression of the umbilical cord. Additionally issues including baby inhaling fluids, higher death rates, neurological issues, cerebral palsy, fractures and brachial plexus traction injuries can occur from this situation.
In spite of the fact that the doctors knew that the drug treatments they were prescribing were of no value or little value, 27% said that they administered antibiotics even though they knew the drugs would not be effective. The most common scenario described was for upper respiratory illnesses that are mostly caused by viruses. Viruses are not affected by antibiotics making the use of those drugs totally worthless in those situations.
The study begins by noting the overall increase of chiropractic utilization in the United States and Canada has risen from 4% in 1980 to 14% in the U.S. by 2015. They report that a high percentage of the people seeking chiropractic care do so for musculoskeletal issues related to back pain.
The study begins by noting that according to some studies, depression is one of the most common mental disorders affecting about 16% of the general population. This issue is about twice as common in women as in men. The authors list the symptoms associated with depression as including “…long-lasting depressed mood, loss of interest or pleasure in hobbies and activities that were once enjoyed, decreased energy, fatigue, feelings of worthlessness, feelings of helplessness, feelings of guilt, feelings of anxiety, difficulty concentrating, difficulty making decisions, insomnia, early-morning awakening or oversleeping, weight loss or weight gain, recurrent thoughts of death and or suicide.”
According to the study authors, erectile dysfunction (ED) is defined as a man’s inability to attain or sustain an erection satisfactory for sexual intercourse. They report that there are two classifications of ED, primary and secondary. Primary ED is a man who has never been able to have an erection, while secondary is the case where a man used to be able to have an erection but is currently unable to.
On the website 
The study begins by discussing the increased usage of complementary alternative medicine (CAM) by children. CAM consists of a wide variety of non-medical forms of health care. While some classify chiropractic as a separate and distinct form of healthcare, many classify it within the umbrella of CAM professions. The authors note that several studies have shown that chiropractic is the most popular form of CAM for children in the U.S. since an initial study in 2007. They report that one in four children with common neurological conditions use some form of CAM.