(The following is #3 in a series of columns entitled Dx IQ from the Society to Improve Diagnosis in Medicine to help you understand how important your role is in getting properly diagnosed.)
Most kids are healthy most of the time. Beyond the usual tumbles and falls, the boo-boos that can be healed with a kiss and a Band-Aid®, beyond the normal childhood illnesses that sweep through classrooms as if by the power of suggestion, kids do tend to be healthy.
However, the mindset that young children are rarely seriously ill is one of the main reasons that they are more likely to be misdiagnosed than adults are. That’s on top of all of the ways that approximately 10 percent of American adults are misdiagnosed every year (See Dx IQ #1: The most important medical issue ever for more). When doctors and nurses expect to see a healthy child with a common short-lived illness, they may miss the uncommon ones.
The top reasons young children are susceptible to a diagnosis that’s wrong or delayed include:
Attitude: Since most children are healthy, and most illnesses resolve on their own, doctors may tend to reassure parents rather than accept concerns are real
Biology: Young children’s bodies and systems are radically different than adults, so they present and respond in unexpected ways
Unequipped: Most children’s emergency room visits are to community or adult hospitals that often don’t have needed kid-sized equipment or pediatric experts. Urgent care centers have similar issues.
Communication: Young children don’t understand or know what is wrong so they’re dependent on parents or caregivers to recognize and then interpret their symptoms
When parents’ concerns are dismissed
Sometimes diagnostic error happens slowly and there is time to catch it and course correct, but every so often it occurs lightning fast. Isabel was a healthy three year old in London who woke up one morning with normal chicken pox and was fighting for her life a few days later.
Her mother, Charlotte Maude, took Isabel to their family physician that Tuesday morning because she “had an innate sense that something was not quite right.” She had a fever of 104 degrees (40 degrees Celsius) with diarrhea and frequent vomiting. However, they were reassured by the family physician.. (Read More)