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How to get more accurate medical diagnoses

Most people, at one time or another, have received an incorrect diagnosis or seen a doctor who's been stumped by their symptoms. Often, it doesn't much matter, since the symptoms go away on their own. But misdiagnoses can cost lives: an estimated 40,000 to 80,000 hospital deaths every year, according to a March paper published in the Journal of the American Medical Association.

One leading reason for such errors? The 18-second rule.

"That's the average time it takes for a doctor to interrupt you as you're describing your symptoms," says Jerome Groopman, professor of medicine at Harvard University and author of "How Doctors Think." "By that point, your doctor has in mind what the answer is, and he or she is probably right about 80 percent of the time - not bad, but not good enough."

So what can you do to increase the odds your own doctor will get it right? Here are six tips:

1. Make sure you can tell your whole story. If your doctor appears to be in a rush and interrupts frequently, you're at greater risk of being misdiagnosed. "Don't assume that just because someone has given you a diagnosis that it's necessarily accurate and complete," says Dr. Steven Palter, medical and scientific director of Gold Coast IVF of Syosset, a reproductive medicine and surgery center. "The patient should communicate to the physician all of their concerns and symptoms. . . . There's rarely only one treatment option, so the patient should ask what are the risks and benefits, and what options does the doctor have experience with and what they don't."

2. Ask your doctor three questions after he or she comes up with a possible diagnosis: Is there anything in my medical history that doesn't fit with your diagnosis for what I have? Then follow up with: What else do you think it could possibly be? And you can ask if it's possible that you have more than one thing wrong with you - migraines, say, along with irritable bowel syndrome.

In addition, suggests Dr. Howard Blumstein, a rheumatologist with a practice in Smithtown and Port Jefferson Station, you should ask: " 'How will this affect my life, my longevity?' And then it's important to ask, 'How can I help myself?' That's in addition to taking the medications. And also, 'Where can I find out more?' For that I refer patients to various resources for their specific condition."

3. Verify any shocking results. Three to 5 percent of the time, something goes wrong with a lab test.

4. Don't discount doctor-patient chemistry. You should feel comfortable conversing with your doctor and vice versa.

5. Acknowledge your quirks. This can help if you think your doctor isn't taking your complaints seriously. Acknowledging that you, say, have a high-strung personality or are a little bit of a hypochondriac or have no tolerance for pain, can let your doctor know that you have insight into your own emotional state. You can then go on to say, I know I get (fill in the blank) when I'm really stressed out, but this pain feels different, more intense, sharper, less diffuse.

6. Allow for the possibility of uncertainty. Sure, we all want a label for our symptoms, but don't push for a definitive diagnosis when your doctor seems unsure.

With Steve Parks

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