Four hundred of nation’s highest-ranked cancer specialists offer perspective on tools and improvements needed
The National Coalition on Health Care (NCHC) and Best Doctors, Inc. today released results of a major joint survey investigating the issue of diagnostic accuracy in cancer. The nationwide survey of 400 leading cancer specialists from Best Doctors’ physician database, audited and certified by Gallup®, assessed how often participating doctors believe misdiagnoses occur, what physicians feel are the most significant barriers to accurately diagnosing and characterizing cancers, and the tools or technology doctors feel would best help them improve diagnostic accuracy rates.
In addition, physicians shared their perspective on which types of cancer they believe are most often misdiagnosed, which issues they believe lead to the most errors in interpretation of pathology specimens, and actions that would best add to increasing the limited availability of misdiagnosis-related data.
Over 1.6 million new cancer cases in the U.S. are projected to occur in 2013, according to the American Cancer Society’s recently released “Cancer Facts & Figures 2013” report. Yet while the type or stage of some of these cases will be misdiagnosed, a key challenge physicians and policymakers alike often cite when it comes to formally measuring and tackling misdiagnosis is a lack of needed hard data on the issue.
Survey responses bear this out, and call for practical steps to be taken. In response to the question “What action would you say would most add to increasing the availability of data on misdiagnosis?” 29% of respondents called for incentives for hospitals from lawmakers to participate in confidential misdiagnosis data gathering and reporting. “Confidential reporting/data sharing on misdiagnosis as part of hospital accreditation” was next with 24.8% of respondents, while 23% called for “increased funding from NIH or other sources for the study of misdiagnosis,” and 16.5% favored “establishing a voluntary misdiagnosis reporting system.”
Some survey results were provocative. For instance, physicians’ responses indicated their perception that misdiagnoses occur less often than published studied indicate. When asked how often they estimate misdiagnosis or incomplete characterizations occur in oncology, the vast majority of respondents (60.5%) estimated zero to 10% of the time. This figure is noteworthy, as published studies indicate significantly higher rates of misdiagnoses overall, from 15-28% of cases (according to The American Journal of Medicine and BMJ Quality & Safety, respectively).
“Does misdiagnosis mean physicians don’t care or aren’t committed? Of course not,” noted David Seligman, chairman and chief executive officer of Best Doctors. “But doctors today are increasingly time-strapped. Many of them are seeing up to 30 patients a day. They’re working in an overburdened health system with fractured or incomplete medical records. All of these things too often directly impact health outcomes – no matter how dedicated or skilled the physician may be.”
Indeed, the largest portion of participants (38.5%) named “fragmented or missing information across medical information systems” when asked what they viewed as the most significant barrier to accurately diagnosing cancer.
When respondents were asked what types of cancer conditions they believed were most often misdiagnosed or mischaracterized, of the 21 conditions named, Lymphoma led the top five by a wide margin. This was followed by Breast Cancer, Sarcomas, Melanoma (increasing among both men and women, according to the American Cancer Society’s recent report), and “Cancer of unknown primary site.” Pathology played an important role in survey results, as well: the largest portion (36%) of respondents called for “new or improved pathology tools or resources” when asked what tools or technology physicians’ hospitals or offices believe would most help improve diagnostic accuracy rates in cancer cases.
NCHC President & Chief Executive Officer John Rother argues that in future national health policy and budget discussions, misdiagnosis should play a much larger role. Highly regarded for NCHC’s 2012 “Curbing Costs, Improving Care: The Path to an Affordable Health Care Future” report, featuring recommendations for federal policymakers and lawmakers to curb costs while improving quality access to care, Rother points out the wasted health care dollars tied to misdiagnoses.
“According to Thomson Reuters, nearly seven hundred billion dollars are wasted in the U.S. medical system each year, much of which is tied to misdiagnosis or people getting the wrong treatment,” Rother said. “Not enough is being done on the state and federal policy end of things to acknowledge and firmly address this critical issue. Given our current health care climate and challenges, as decision-makers become more aware of the frequency of misdiagnosis and the enormous costs associated with it, they have a sizeable opportunity to make diagnostic accuracy much more of a ‘front and center’ issue in health care.”
“These findings should serve as a catalyst for a critical national discussion,” agreed Evan Falchuk, vice chairman of Best Doctors. “Lawmakers and health care stakeholders have an opening to take firm steps to begin formally measuring and addressing misdiagnosis – similar to how health care decision-makers began taking firm steps to combat medical error and improve patient safety rates 15 years ago. Taking solid action made all the difference to the health of countless Americans as a result.”
To view full results of the survey, visit www.bestdoctors.com/NCHC_BD_survey or http://nchc.org/node/1285.
For further information, visit www.bestdoctors.com.