Many of us have had the experience of consulting more than one doctor regarding a medical concern merely to learn that the doctors consulted do not agree with each other. In the event a misdiagnosis could actually mean the difference between life and death this might create a serious problem for the patient. When the patient is made aware of each physician's conclusions and the reason for those conclusions the the patient can reach an informed decision based on his or her level of risk tolerance. It becomes more complicated, however, when the one physician who is on the right track does not communicate his or her suspicions and the other physicians are missing the signs and not ordering the appropriate tests.
One such situation happened in the following reported case. A number of doctors had a chance to detect the man's prostate cancer when it was in its early stages. The man first consulted with his primary care physician (PCP), a general practitioner, with urinary problems at 56 years old age. The general practitioner decided that the issues were not associated with cancer even though no testing was done to rule out cancer.
Ten months afterwards the man was examined by a urologist who performed a physical examination on the prostate gland and ordered a PSA blood test. As it turned out this urologist did not practice in the patient's insurance network and so the patient went to a second urologist. The PSA test ordered by the first urologist came back and that urologist advised a biopsy. However, that recommendation apparently did not get communicated to the family doctor or the urologist approved by the insurance company. The second urologist concluded that the examination of the prostate was normal and that there was no evidence of cancer.
It took another two years when the patients prostate cancer was at long last detected. By that time, the cancer had spread beyond the prostate and was now advanced. Had the cancer been diagnosed when the patient initially complained of urinary problems, when he saw the first urologist, or even when he saw the second urologist, it would not have yet spread and, with treatment, the patient would have had approximately 97% likelihood of surviving the cancer. Since the cancer was already advanced , however, the patient was not expected to survive more than five years. The law firm that handled this matter documented that they were able to obtain a settlement during jury selection at trial for $2.5 million on behalf of the patient.
As the claim discussed above reveals, having more than one physician for the same issue might lead to multiple mistakes. The first error consisted of not following the screening guidelines. This was a mistake committed by both the general practitioner and the second urologist. Additionally there was the failure of communication among the several physicians. Although there is no way to know whether the family doctor or the second urologist would have followed up on results of the PSA test from the first urologist or on that urologists suspicion and recommendation they at a minimum would have had information and perspective they were missing.
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