PRACTICE PARTNER
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A
woman Dr. Groopman calls Anne was
misdiagnosed by 30 doctors, until one
brought a fresh take. Anne had celiac
disease, but was believed to have an eating disorder. “The 31st member of Anne’s
team didn’t follow an algorithm or treatment guideline,” wrote Dr. Groopman. “He
thought creatively, rearranged the pattern of
her symptoms and clinical findings into a
different picture, and made a diagnosis that
had eluded everyone. Once processes and
procedures are set in motion after anchoring on to a particular diagnosis, it becomes
very difficult to break the chain.”
Lesson: Don’t assume one size fits all.
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I
nformation doesn’t always come readily.
Dr. Weston recalls asking patients if they
had chest pain. The answer might be “no.”
Yet reframing the question – “Have you had
any uncomfortable feelings in your chest
like tightness, heaviness or pain?” – might
elicit a different answer. “This question
reduced my risk of missing a diagnosis of
angina,” he says.
Lesson: Don’t assume the patient is always
forthcoming.
I
llnesses and conditions aren’t just about
“broken parts,” says Dr. Weston. You can’t
downplay the role of social and psychological factors in causing or alleviating illness.
Lesson: Don