Dialogue Volume 10 Issue 3 2014 | Page 33

PRACTICE PARTNER 5 6 7 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. 8 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