From Wall Street to Main Street: Misdiagnosed

By Evan Falchuk

According to news reports actor Michael Douglas, perhaps most famous for his role of Gordon Gekko in Wall Street, is suffering from stage IV throat cancer.

He started complaining about symptoms to doctors earlier this year.  His doctors didn’t find anything to explain the problem until months later, when they discovered a walnut-sized tumor in his throat.  Even though doctors had originally told him they couldn’t find anything wrong, Douglas and his wife, actress Catherine Zeta-Jones were sure something wasn’t right.

Still, after months of feeling the pain creep up on him, of having a dry throat and hoarse voice, the news of his cancer came as little surprise to both Hollywood stars.

“It wasn’t a huge shock. I knew something was up. He knew something was up,” said Zeta-Jones.

It’s an all-too familiar story.  Being a rich and famous celebrity can make you special.  But when it comes to the right care, you’re as ordinary as the next guy.

How do I know?  Here at Best Doctors, we’ve got a lot of experience and data on what happens to regular people when they get sick.

We get our data from the programs we run.  In our work, members call us when they’re trying to make decisions about their health care.  We do whatever we can to make sure the person knows what’s really wrong and what to do about it.  The people we serve work in factories, behind desks in an executive suite, in retail stores, behind the wheel of a truck – it’s a cross-section of Main Street America.

Our call data is fascinating – and disturbing.

More than one-third (34%) of our calls are from people who haven’t been able to get a diagnosis or have symptoms that aren’t getting better.  They’re trying to figure out what to do, but are finding that the system is failing them, just when they need it to work.

Why does this happen?  I think it’s because health care has become increasingly depersonalized.  Medicine is being turned into something like an assembly line process – 15 minutes per patient, 30 patients a day, please fill out the following form and see the nurse at the front when we’re done. Medicine – the art of listening to patients, thinking about their problems, and offering solutions – is slowly dying under this pressure.  Doctors know this, and they don’t like it.

The trouble for regular people is that you haven’t a clue this is going on until you get sick.

You can’t fix the system, but you can protect yourself from its failings.  Stand up for yourself.  Use every resource available to you to make sure things go right.  Insist that your doctors hear your concerns.  And above all, don’t let anything happen until you’re sure you’re doing the right thing.

  • http://www.healthcontentadvisors.com/blog Janice McCallum

    I’m not sure I agree that depersonalization of our healthcare system is the biggest problem leading to misdiagnosis. I don’t think we’ve been that good at diagnosing in the past. But, I am hopeful that emerging clinical decision support systems will improve the ability of clinicians–and patients–to diagnose their conditions.

  • http://www.seefirstblog.com Evan Falchuk

    Hi Janice, thanks for your comment.

    You raise a provocative point: was the quality of medical care – in terms of diagnosis and treatment – better in the past?

    I wish there were data on this. One place to consider is what well-trained doctors in underdeveloped countries do, since they are sort of practicing in an environment like how our country used to be decades ago. They spend lots more time with patients, don’t have pressure to refer the patient on, or have them do a diagnostic test someplace. They seem to do a very good job with figuring out what’s wrong – and the relationship with their patients something much more profound than what you see here in the US.

    I agree that any kind of decision-support system – really anything that gives the doctor pertinent, useful information about the person in front of them – is a good thing.

    But why not give them the one thing — time — they really need the most?

  • Anonymous

    Evan,
    You are definitely on the right track with this one. The solution, however, already exists. It’s called primary care. The problem is politicians, wonks, and suits have created a system that IS CANCEROUS to primary care. The proposed solutions are guaranteed to FAIL. Leaders like L Gordon Moore have published studies demonstrating the essential need for 1. a personal, longitudinal relationship with your doctor 2. care coordination 3. comprehensive services and 4. prompt access. There a hundreds of us giving this type of care across the country. We are ignored because the status quo has plenty $$$ to lose if we “do the right thing” for our patients. Maintaining health and treating illness are HUMAN yet imperfect endeavors. Insurance makes patients PRODUCTS and rapes them from being unique individuals with intimate and cultural beliefs and philosophies concerning health and illness.

  • Michelle

    It’s an assembly line. We have turned the clinics into factories. Aside from that, the doctors seem to not have the ability to deduce. Ego plays a part here and once they make a decision, they go full throttle and never reconsider that decision.

  • Alisa

    Will you be my MD?

  • http://www.medicalnegligenceie.com/cancer-misdiagnosis-compensation-claim/ Cancer Misdiagnosis

    hello Evan Falchuk
    My mother has voice problem from last five years.Her voice is not clear.And day by day voice is becoming unclear to hear.Her right hand nerve is also get drying day by day.We have showed her to Apollo in Delhi but no result.
    Is it cancer ? Pls provide the solution …any one is invited.

  • "Medicine is learned by the bedside and not in the class room. Let not your conception of manifestations of disease come from work heard in the lecture room or read from the book: see and then research, compare and control. But see first."
    - Sir William Osler, MD
    The Father of Modern Medicine
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