Many people have had the experience of getting a second opinion on a health issue just to discover that they have different opinions and different recommendations. In the event a an incorrect diagnosis could actually mean the difference between life and death this might present a serious problem for the patient. The importance of such communication is not necessarily negated due to the fact the patient fails to go back to any of the physicians. Thus when a physician has information or reaches a diagnosis that the patient needs immediate follow up or treatment it is critical for that doctor to communicate that to the patient and possibly also at least the patient's primary care physician.
One such situation happened in the following reported case. A number of doctors had a chance to diagnose the man's prostate cancer before it spread A male patient visited his family physician and reported having urinary problems. He was 56 at the time. The family physician assumed that the patient's problems were not caused by cancer. As a result, the family doctor failed to order any diagnostic testing, for example a biopsy and failed to refer the individual to a urologist.
Ten months later the individual was examined by a urologist who did a physical examination on the prostate gland and did a PSA blood test. The man then found out that this urologist was not an approved provider under the patient's insurance and so the patient consulted with a second urologist.
The PSA test ordered by the first urologist came back and that urologist recommended a biopsy. However, that recommendation evidently did not get related to the family doctor or the urologist approved by the insurance company. The second urologist concluded that there were no abnormalities present with the prostate and that there was no indication of cancer.
It was another 2 years before the patient's prostate cancer was finally detected. By that time, the cancer had spread outside the prostate and had metastasized. Had the cancer been detected when the patient initially complained of urinary problems, when he saw the first urologist, or even when he saw the second urologist, it would have still been contained in the prostate and, with treatment, the patient could have had approximately 97 percent chance of surviving the cancer. Given that the cancer was by now advanced at the time of diagnosis, however, the patient was not expected to live more than five years. The law firm that handled this claim published that they were able to obtain a settlement during jury selection at trial in the amount of $2,500,000 on behalf of the patient.
This lawsuit thus demonstrates two main varieties of failures. There was the failure on the part of the PCP and the second urologist to not follow the proper screening guidelines. Additionally there was the failure of communication among the various doctors. If the patient had been able to stay with the unapproved urologist the patient would have known that cancer was a possibility and that a follow up biopsy was recommended. If the other physicians would have agreed with that recommendation or would have passed this information to the patient if they had received it is unknown but then the error would have been entirely theirs.
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