Her cancer has not been detected, now this grandmother wants to help others get the right diagnosis



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Drummond is part of the untold number of Americans affected each year by a medical diagnosis error. It is difficult to determine exactly how much.

"There is not a single health care organization in the country that measures their diagnostic performance," said Dr. Mark Graber, Chief Medical Officer of the Society for the Improvement of Diagnosis in Medicine.

A 2014 study published in the medical journal BMJ Quality & Safety, at least one in 20 American adults will suffer from misdiagnosis each year. According to Graber, many of these errors are trivial, although it is estimated that 40,000 to 80,000 deaths are related to misdiagnosis each year. Beyond the consequences for the health of the patient, a misdiagnosis can also mean a loss of money on unnecessary tests and treatments.

The central question is that diagnosis is complicated work and subject to human error.

"There are more than 10,000 diseases, but only 200 symptoms," said Graber. "So when you have a given symptom, it can average on average 50 things."

Doctors, using modern tests, make the correct diagnosis in the vast majority of cases, but Mr. Graber said that it was possible to do better. The company responsible for improving diagnosis in medicine was established in 2011 to support education and field research and to encourage the efforts of physicians, patients and health care organizations to solve the problem .

The non-profit organization provides patient resources and a toolbox to help prepare for a doctor's appointment to www.improvediagnosis.org.

Dr. Andrew Olson is an assistant professor of medicine and pediatrics at the University of Minnesota's School of Medicine, as well as co-chair of the Society's Education Committee for Improving Diagnosis in Medicine. He added that one of the best strategies to improve diagnostic reasoning is to identify the cases where the diagnosis went wrong and learn from it.

The reality, however, is that many faculties of medicine do not have courses focused on the diagnostic process.
Medical schools are starting to understand the importance of education to diagnosis, but investigations show that more attention needs to be paid, Olson said. In U of M, for example, he runs a diagnostic course that teaches medical students case studies.
Another important lesson for physicians is to work with patients and involve them in the diagnostic process, Olson added.

According to a 2015 report entitled "Improving Diagnosis in Health Care", published in 2015 by the Institute of Medicine of the National Academies of Science, Engineering and Health, the diagnosis of misdiagnosis will require the collaboration of patients, family members and many health care professionals.

The report identifies steps to reduce errors, such as:

  • Develop organizational cultures in health care that promote discussion and feedback.

  • Recognize the importance of radiologists and pathologists in a diagnostic team.

  • Expand monitoring to identify and learn errors.

Minnesota is one of many states with legislation requiring hospitals and outpatient surgery centers to report medical errors. However, the list of 29 "health adverse events" to report does not include misdiagnosis.

Hospital associations of Wisconsin and Minnesota also run voluntary reporting programs to monitor the quality of hospitals – including patient surveys on the timeliness and communication of doctors and nurses – but there are no specific diagnostic measures.

Lisa Drummond (left) poses with her daughter Melissa Fauber in her home in New Richmond, Wisconsin. Drummond, who was diagnosed with colorectal cancer in December 2018, said she wanted others to learn from her story. Michael Brun / RiverTown Multimedia

It started for Drummond about two years ago with a change in his stool. She was on antidepressant medication following the suicide of her son, Jeffery Fauber. Drummond, a long-time nurse, said she knew how to look at side effects, including diarrhea. She went to her doctor, but chose to continue taking her medication. Then she said that she was starting to feel tired.

This time it was suggested that his diet was to blame. But over the weeks, she said that she was weakened and that her abdomen had become distended and painful. "Every time I went there, I told my doctor that something was wrong. There is just something, I can not say. "

She finally underwent a colonoscopy that revealed microscopic colitis or inflammation. The drugs seemed to help, but Drummond said the pain would come back soon. After the last push, her daughter, Melissa Fauber, took Drummond to the emergency room.

A series of tests were ordered and, for the first time, a scan of Drummond's abdomen. It was then that a crying doctor pulled a chair near his bed.

"She took my hand and said:" Lisa, I hate to tell you that … your abdomen is full of cancer. "

Drummond was transported to a Twin Cities hospital where she said she surprised the staff with her positive attitude.

Drummond said that she had made peace with her former doctors and that she had no ill will towards them. More than anything, she said that she was relieved to know what caused her all this pain.

"I'm happy to know what I have now," she said, "and I can develop a plan and we can deal with it."

The loved ones have been a source of support for Lisa Drummond (center) since the diagnosis of her cancer. She is pictured with (front, left) Loren Drummond, Alby, Jaxson, Zakary and Emily Fauber; and (from the left) Melissa Fauber, McKenna, Starr and Allen Fauber. Submitted photo

The family was a source of comfort for Drummond after the diagnosis. Her support network includes her daughter Melissa and her son Allen Fauber, her friend Shelley Barr, and extended family and grandchildren Starr, McKenna, Julian, Jaxson, Zakary and Alby. But Drummond said that she would have liked to have an ally earlier to defend her during the diagnostic process.

A friend or family member can be a helpful resource for a health problem. For complex medical problems or if geography separates a patient from his or her loved ones, a professional patient rights advocate can intervene.

"Especially when it's complicated or you really feel that you need someone to explain the process to you, it's always a good idea to have someone in one of them." your corner, "said Jill Fitzpatrick, who runs a patient advocate in Minnesota.

Patient Advocates offer a variety of services, ranging from patient accompaniment to appointments, through to the management of health insurance and billing issues.

Fitzpatrick said she took a collegial approach when she saw a respectful but firm doctor: "I am educated on me, you are educated on medicine. Let's work together so that I have a positive result. "

Another tip, if patients feel they are not being heard by their provider, is to look up a member services phone number on their insurance card to see if another provider is present on their card. network, she said.

Drummond said she did not want to scare anyone by mistrusting doctors and let people know that there is no shame in asking for a second opinion. She said that she regretted not having looked for it sooner.

"And your doctor should not be offended," she added. "If they're offended, they're probably not the right doctor for you."

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