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Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Hysteria. Neurasthenia. Shell shock. When the Diagnostic and Statistical Manual of Mental Disorders was first published in 1952, it was meant to do away with such hypothesized, dubious disorders--now we had science on our side! But the mental health diagnoses of ages past should not be forgotten. In (Mis)Diagnosed, social worker Jonathan Foiles, author of the acclaimed This City Is Kiling Me, returns with this look at how they shed light on how we used to view mental suffering, and how our biases defined and continue to define mental health. Consider "drapetomania," for example, a nineteenth-century diagnosis concocted by a Southern doctor who theorized that something must be wrong with slaves who sought to escape to freedom, and came up with this term to name the irresistible compulsion to flee. This diagnosis was laughable to most even then, yet some psychiatric diagnoses (e.g., schizoaffective disorder) maintain an alarming racial bias and raise the question whether or not scientific racism is really that far removed from our present-day reality. Homosexuality, remember, was not removed from the DSM until 1980. The series of failed diagnoses Foiles chronicles here are, he argues, all a way of ignoring our societal responsibility for the conditions we helped create. Our gradually increasing understanding of the brain may help make diagnosis more biological than observational, but still fails to take into account the social context that both creates suffering and labels certain existences and beliefs as pathological. (Mis)Diagnosed ultimately is a call to make diagnosis more interactive with one's environment in a way that is fair to those who are suffering and can help give them hope.
"Berger movingly details her journey to healing. Her indefatigable quest...underscores the fact that there is no such thing as one size fits all in medicine."—Gayatri Devi, MD, clinical associate professor, NYU School of Medicine, and author of A Calm Brain Taking charge of your health has never been so important as it is today. Jody Berger has discovered this first hand: at forty-three, the award-winning journalist and marathoner sees a doctor about a minor tingling sensation in her hands and feet. One MRI later, she is diagnosed with multiple sclerosis and told to pick a drug and accept her fate. Instead Jody starts asking questions—only to receive a different diagnosis from each specialist she turns to, from vitamin deficiencies to metal toxicity to depression. In this powerful, witty, and eye-opening account of her misadventures from misdiagnosis to miraculous recovery, Jody offers insightful tips on how to ask doctors the right questions to get the answers and treatment you need, listen to your body, and choose health over illness. After all, while we can't always heal, we can always take control of our health and ourselves—starting now. "In this compelling, beautifully written book, Jody Berger offers an empowering look at the importance of finding the strength and confidence to take charge of your health."—Mary Shomon, New York Times bestselling author and patient advocate
Jean Sharon Abbott was misdiagnosed as a young child with Spastic Dipligia, a form of Cerebral Palsy. After 33 years of countless doctors visits, medical procedures,unnecessary medications and surgeries, she was correctly diagnosed with Dopa Responsive Dystonia (DRD). Jean enjoys all the adventures of her new life, but wouldn't change the journey that brought her to where she is today. Her positive attitude is highly contagious as she encourages others to appreciate the little things in life.
A trailblazing, conversation-starting history of women’s health—from the earliest medical ideas about women’s illnesses to hormones and autoimmune diseases—brought together in a fascinating sweeping narrative. Elinor Cleghorn became an unwell woman ten years ago. She was diagnosed with an autoimmune disease after a long period of being told her symptoms were anything from psychosomatic to a possible pregnancy. As Elinor learned to live with her unpredictable disease she turned to history for answers, and found an enraging legacy of suffering, mystification, and misdiagnosis. In Unwell Women, Elinor Cleghorn traces the almost unbelievable history of how medicine has failed women by treating their bodies as alien and other, often to perilous effect. The result is an authoritative and groundbreaking exploration of the relationship between women and medical practice, from the "wandering womb" of Ancient Greece to the rise of witch trials across Europe, and from the dawn of hysteria as a catchall for difficult-to-diagnose disorders to the first forays into autoimmunity and the shifting understanding of hormones, menstruation, menopause, and conditions like endometriosis. Packed with character studies and case histories of women who have suffered, challenged, and rewritten medical orthodoxy—and the men who controlled their fate—this is a revolutionary examination of the relationship between women, illness, and medicine. With these case histories, Elinor pays homage to the women who suffered so strides could be made, and shows how being unwell has become normalized in society and culture, where women have long been distrusted as reliable narrators of their own bodies and pain. But the time for real change is long overdue: answers reside in the body, in the testimonies of unwell women—and their lives depend on medicine learning to listen.
Our brightest, most creative children and adults are often being misdiagnosed with behavioral and emotional disorders such as ADHD, Oppositional-Defiant Disorder, Bipolar, OCD, or Asperger?s. Many receive unneeded medication and inappropriate counseling as a result. Physicians, psychologists, and counselors are unaware of characteristics of gifted children and adults that mimic pathological diagnoses. Six nationally prominent health care professionals describe ways parents and professionals can distinguish between gifted behaviors and pathological behaviors. ?These authors have brought to light a widespread and serious problem?the wasting of lives from the misdiagnosis of gifted children and adults and the inappropriate treatment that often follows.? Jack G. Wiggins, Ph. D., Former President, American Psychological Association
Schizophrenia is the most widely known and feared mental illness worldwide, yet a rapidly growing literature from a broad spectrum of basic and clinical disciplines, especially epidemiology and molecular genetics, suggests that schizophrenia is the same condition as a psychotic bipolar disorder and does not exist as a separate disease. The goal is to document and interpret these data to justify eliminating the diagnosis of schizophrenia from the nomenclature. The author reviews the changing diagnostic concepts of schizophrenia and bipolar disorder with a historical perspective to clarify how the current conflict over explanations for psychosis has arisen. That two disorders, schizophrenia and bipolar, known as the Kraepelinian dichotomy, account for the functional psychoses has been a cornerstone of Psychiatry for over 100 years, but is questioned because of substantial similarities and overlap between these two disorders. Literature in the field demonstrates that psychotic patients are frequently misdiagnosed as suffering from the disease called schizophrenia when they suffer from a psychotic mood disorder. Such patients, their families, and their caretakers suffer significant disadvantages from the misdiagnosis. Psychotic patients misdiagnosed with schizophrenia receive substandard care regarding their medications, thus allowing their bipolar conditions to worsen. Other adverse effects are substantial and will be included. Liability for medical malpractice is of critical importance for the mental health professionals who make the majority of the diagnoses of schizophrenia. The concept put forward in this work will have a discipline-altering impact.
AN APPLE BOOKS PICK OF THE MONTH “Masterfully written, distinctively researched, deeply humane . . . Genius.”—ANTHONY SWOFFORD, author of Jarhead “A major contribution . . . A necessary book.”—JOHANN HARI, author of Lost Connections “This book is a triumph of the spirit and the flesh.”—ELIZA GRISWOLD, Pulitzer Prize–winning author of Amity and Prosperity In this stunning debut—both a memoir and a work of investigative journalism—writer Sarah Fay explores the ways we pathologize human experiences. Over thirty years, doctors diagnosed Sarah Fay with six different mental illnesses—anorexia, major depressive disorder (MDD), anxiety disorder, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and bipolar disorder.Pathological is the gripping story of what it was like to live with those diagnoses, and the crippling impact each had on her life. It is also a rigorous investigation into the Diagnostic and Statistical Manual of Mental Disorders (DSM)—psychiatry’s “bible,” the manual from which all mental illness diagnoses come. Yet as Fay found out, some of our most prominent psychiatrists have been trying to warn us that the DSM is fiction sold to the public as fact. In Pathological, former advisory editor at The Paris Review and award-winning writer Fay calls for a new conversation about mental health diagnosis, one based on rigorous transparency. With exquisite detail and a precise presentation of fact, she digs up her own life at the root to finally ask, Is a diagnosis a lifeline or a self-fulfilling prophecy? Powerful, mesmerizing, and unputdownable, Pathological sits alongside the other brave and inspiring classics of our time that explore a more intelligent, forgiving, and nuanced approach to human suffering.
An exposé on Big Pharma and the American healthcare system’s zeal for excessive medical testing, from a nationally recognized expert More screening doesn’t lead to better health—but can turn healthy people into patients. Going against the conventional wisdom reinforced by the medical establishment and Big Pharma that more screening is the best preventative medicine, Dr. Gilbert Welch builds a compelling counterargument that what we need are fewer, not more, diagnoses. Documenting the excesses of American medical practice that labels far too many of us as sick, Welch examines the social, ethical, and economic ramifications of a health-care system that unnecessarily diagnoses and treats patients, most of whom will not benefit from treatment, might be harmed by it, and would arguably be better off without screening. Drawing on 25 years of medical practice and research on the effects of medical testing, Welch explains in a straightforward, jargon-free style how the cutoffs for treating a person with “abnormal” test results have been drastically lowered just when technological advances have allowed us to see more and more “abnormalities,” many of which will pose fewer health complications than the procedures that ostensibly cure them. Citing studies that show that 10% of 2,000 healthy people were found to have had silent strokes, and that well over half of men over age sixty have traces of prostate cancer but no impairment, Welch reveals overdiagnosis to be rampant for numerous conditions and diseases, including diabetes, high cholesterol, osteoporosis, gallstones, abdominal aortic aneuryisms, blood clots, as well as skin, prostate, breast, and lung cancers. With genetic and prenatal screening now common, patients are being diagnosed not with disease but with “pre-disease” or for being at “high risk” of developing disease. Revealing the economic and medical forces that contribute to overdiagnosis, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, excessive worry, and exorbitant costs, all while maintaining a balanced view of both the potential benefits and harms of diagnosis. Drawing on data, clinical studies, and anecdotes from his own practice, Welch builds a solid, accessible case against the belief that more screening always improves health care.
Following two broken marriages and her mother's suicide, Jane came into the happiest time of her life with a new love -- only to have it end tragically. Her death certificate states that she died of "metastatic carcinoma of unknown primary" -- medical lingo for a cancer whose source remains a mystery. That explanation fails to reveal how Jane was placed in harm's way by health-care practitioners who belittle one another's valuable skills, refuse to cooperate, misdiagnose (or make no attempt to diagnose), and who believe that their treatment plan is the only plan, thereby putting the patient at risk. This poignant story, told through Jane's private journals by her author husband, is a cautionary tale for everyone caught in the crossfire of America's medical "cold war." Book jacket.