Baylor College of Medicine researchers identified factors that could contribute to diagnostic error, specifically those related to patient-physician interaction. Upon reviewing diagnostic error narratives, they found that approximately 75% included discussions about clinicians' behaviours that the patient or family members thought contributed to the error. Researchers identified four themes of behaviours inconsistent with patient-centered care and where patients indicated were related to the diagnostic process. These themes are:
- Ignoring patients' knowledge: Many patients felt that clinicians ignored or dismissed their reports of clinical clues such as worrisome symptoms, changes in patient status or failure to improve, which resulted in their diagnostic error;
- Disrespecting patients: The manner in which clinicians communicated (being disrespectful, stereotyping or being rude) with patients and families may have contributed to diagnostic error;
- Failing to communicate: This included ineffective communication styles to outright refusal to speak with patients and families. Some reported clinicians being unresponsive to questions and failing to communicate directly with patients and families; and
- Engaging in manipulation or deception: Least frequently, patients felt their physician was using fear to influence them in a certain direction or was misleading or misinforming them. For instance, telling a patient he or she was going to die without surgery which was unneeded.
Researchers say patients and families can often identify problems that are harder to pin-point through traditional data sources and that there are no current policy or practice initiatives to gather patient experiences related to misdiagnoses.