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The hazards of diagnosis
A Schattner1, N Magazanik, M Haran
1Department of Medicine, Kaplan Medical Centre, POB 1, Rehovot, Faculty of Medicine, Hebrew University Hadassah Medical School, Jerusalem, Israel. amimd@clalit.org.il
Summary
Diagnoses can have negative impacts on patients, including diagnostic errors and loss of autonomy. Physicians must be aware of these risks and practice humility and sensitivity when delivering diagnoses.
Area of Science:
- Medical diagnosis
- Clinical decision-making
- Patient communication
Background:
- Diagnosis is often viewed as the culmination of clinical effort.
- Potential adverse outcomes following diagnosis are frequently overlooked.
Purpose of the Study:
- To identify and discuss the potential negative consequences and pitfalls associated with the diagnostic process.
- To emphasize the importance of considering post-diagnostic implications in clinical practice.
Main Methods:
- Qualitative analysis based on authors' personal clinical experiences.
- Synthesis of insights from peer discussions.
- Comprehensive literature review on diagnostic outcomes.
Main Results:
- Identified pitfalls include diagnostic momentum, premature diagnostic closure, patient distress, stigma, loss of patient narrative, incomplete diagnostic characterization, overlooking comorbidities, physician disengagement post-diagnosis, and erosion of patient autonomy.
- These issues highlight significant risks associated with the diagnostic process and its delivery.
Conclusions:
- Physicians must recognize the potential harm linked to diagnostic closure and patient communication.
- Practicing humility, verification, and patient-centered sensitivity can mitigate diagnostic hazards and improve care quality.
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