The Human and Financial Cost of Misdiagnoses and Incorrect Treatment
Millions of people around the world are affected by medical diagnostic errors or incorrect treatment plans. There are various reasons for this, including:
A single physician might not have all the answers
One condition may share similar symptoms to another, or the presenting symptoms may be unusual, making diagnosis difficult or complex
The latest treatments (and clinical trials) might not be available at a particular medical center
There is also a reasonable chance that even if diagnosed correctly, a second physician may recommend an alternative treatment plan that could potentially carry less risk
Recent MediGuide case
A 44-year old woman experiences chronic persistent pain in her lower back and buttocks. She is diagnosed with Bertolotti’s Syndrome, a rare (affects less than 10% of the population), frequently misdiagnosed spinal condition. Treatment varies, but most patients achieve positive results with non-surgical interventions. Still, our member’s treating physician schedules spinal fusion surgery.
Unsure about having the surgery and concerned about the long recovery period together with the medical uncertainty of a successful outcome, she reaches out to MediGuide for a medical second opinion (MSO). A MediGuide nurse case manager conducts a detailed telephonic intake and, since the surgical date is rapidly approaching, expedites the case.
Within 3 days of receiving the case medical records, expert physicians at Mass General Brigham Hospital provide a detailed medical second opinion review. Disagreeing with the initial diagnosis and citing it as presumptive based on what the MRI and bone scans reveal, they change the diagnosis, believing Sacroiliac Joint Syndrome is better suited to the member’s particular case.
Ruling out surgery as a first line of treatment, they recommend a minimally invasive treatment plan of spinal injections and a nerve block procedure. If the treatment is unsuccessful, they recommend radiofrequency ablation, a procedure that uses heat to reduce or stop pain transmission.
During the MSO report discussion with her nurse case manager, the member expresses gratitude for the hard work and quick MSO turnaround. She is relieved not to undergo surgery, plans on following the advice of MSO experts, and is looking forward to consulting with a spine specialist to get started on her treatment.
The goal should always be surgery avoidance wherever possible, primarily because of the risk to the patient but also because of surgical cost savings (in this case ±€20 000 depending on the market) and other long-term benefits such as:
Faster rehabilitation (quicker return to work and family)
Fewer or lower health insurance and income protection claims (claims impacted by prolonged recovery times)
Better health outcomes and ongoing quality of life
Misdiagnosis impacts all aspects of healthcare, including healthcare providers, employers, health insurance providers, and, most importantly, people diagnosed with medical conditions. Ultimately, effective treatment depends on the right diagnosis. All the more reason to ensure that your members or employees are aware of and utilize MediGuide’s medical second opinion service.
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