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30% of all Japan's medical diagnoses said to be mistaken

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A man went to a doctor complaining of lower back pains. Vertebral swelling, said the doctor. He recommended an operation. The operation was performed. The pain persisted. Had the diagnosis been wrong? The patient went back for additional tests. An MRI scan revealed an aneurism. A second operation saved the patient’s life. He was lucky. An aneurism can burst – fatally – any time. There’s no time to waste on useless surgery.

A woman suffered from eye trouble diagnosed as glaucoma. The prescribed eye drops didn’t work. It wasn’t glaucoma. It was a brain tumor, a CT scan showed. The tumor was removed. The patient survived but lost the vision in her right eye.

We go to doctors confident they know what they’re doing. They don’t always. In 1963, the eminent Tokyo University neurologist Shigeo Okinaka, looking back on his own illustrious career, said 14.2% of his diagnoses had been mistaken. To a layman that sounds shockingly high. It’s not. Modern estimates of misdiagnoses in the medical field as a whole are roughly 30%, reports Shukan Post (April 28).

It’s enough to drive a sick person to despair. Are doctors to be trusted at all? Why, given their rigorous training and the wondrous scientific instruments at their disposal – MRI and CT scanners, for instance – should so many errors occur?

Neurologist Kimihiro Yoneyama, to whom Shukan Post puts the last question, offers two partial explanations. One is the increasingly narrow specialization of doctors.  Each knows his or her own field but little outside it, making a holistic approach difficult. Another is the sheer stress the overburdened medical establishment is under from the rapidly aging population.

Were things better when medicine was less complex and less scientific and doctors made house calls? The vastly expanded life expectancy of our own day testifies in favor of modern techniques, but individual episodes give one pause.

A patient went to an ear, nose and throat specialist for treatment of clogged nasal passages. The doctor prescribed allergy medicine. Which didn’t work. A second doctor the patient consulted found a giant polyp. Can a doctor miss a thing like that? Apparently.

Or take an affliction like human papillomavirus infection. It causes warts and lesions in mouth, throat and genitals. It can be cancerous. It might not be. It’s a fine line between deadly and benign. Doctors walk it all the time. They can’t always be right.

A patient with flu symptoms was given antibiotics, which proved useless. A subsequent examination turned up an infection, harmless enough in early stages but potentially serious to the point of requiring prolonged hospital treatment if not attended to promptly.

It’s easy to blame doctors, and sometimes they deserve it, but they deal with an endlessly complex organism, with the next patient and the one after that awaiting their turn. Sometimes, Shukan Post suggests, it may be the patients who are to blame – for failing to observe their symptoms precisely and explain them clearly.

In any case, Yoneyama advises, “have the courage to change doctors, Seek multiple opinions. Don’t feel you owe it to your doctor not to, just because you’ve been his or her patient for a long time”

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"d 14.2% of his diagnoses had been mistaken. To a layman that sounds shockingly high. It’s not. Modern estimates of misdiagnoses in the medical field as a whole are roughly 30%, reports Shukan Post ("

This is the crux of the article. To prescribe any medication in Japan, a doctor MUST make a diagnosis. I am not sure, but I think it is necessary for any treatment whatsoever. Doctors are people. Communication by most people is not great. A lot of conditions or symptoms could be anything or nothing at all.

Here is the killer part of the statement that is actually fantastic. This doctor believes that 86% of his diagnoses were correct and even the muckraking Shukan Post seems to grudgingly admit that 70% of diagnoses were correct. Then factor in that the ERROR includes ALL CAUSES and the correct diagnoses must be entirely correct. I would say that is remarkable. You could also continue and say that, in most cases, the erroneous treatment is probably not going to HARM a patient, and you can lump those in with the good cases. What you come up with is that going to see a doctor is very likely to let you figure out what your problem is, and it is unlikely to make you worse off. Seems like a bargain to me. Other industries are probably doing a lot better, but when you think of this as a person to person service industry, it is doing pretty well.

If it were socially acceptable for a doctor to just shrug their shoulders or prescribe placebos, we could probably get the error rate down quite a bit more. "Take two aspirin and call me in the morning" takes care of a lot of health problems.

4 ( +4 / -0 )

Would be far more helpful if you could place these #s in a global context.

One thing I've noticed as a parent is they try to throw antibiotics at a kid no matter how minor the symptoms or unclear the actual illness is.

3 ( +3 / -0 )

I'm not a parent but I would be mortified knowing how kidz are group injected and given flu shots, fever shots, cold shots, anti future shots...for me that's just unnecessary and a profit maker, but I am no medical expert.

Personally it took several years and false diagnoses for me to get a simple situation sorted. But is that the health system here or is it simply the process of going in and renting a doctors time for 5-10 minutes.

The process is go in, wait half an hour, see the doc for 5. Then you pay for his time and his expert advice and he sends you to his buddy pharmacy.

I mean...hey what can go wrong with a 5 minute diagnosis?

2 ( +2 / -0 )

My wife was misdiagnosed twice. Once with a non-existent cancer which scared the begeesus out of all of us and once for an existent brain problem that could've killed her Fortunately a non-medical friend 'guessed' at the real cause and we got another hospital to help. My kid was diagnosed properly but the proposed 'cure' probably would've caused severe problems so we rejected it.

Whenever I find my family or I in a situation with a doctor, we watch very carefully, do the google research, and think about what they say. People should know something about their disease / medical problems and not just rely on one person with a five-minute interview.

thepersoniamnow, wait half an hour? Really? Last week I waited three hours for a three minute interview where the doctor said "Continue doing what you're doing."

8 ( +8 / -0 )

I am always hesitant with Japanese doctors especially those not internationally trained provide a diagnosis. I concur with borscht. It might be true in any situations, but it is definitely in Japan. Some of their knowledge is simply outdated. I have seen quite a few people miss diagnosed here. Some were life threatening. The only safety net is that people are encouraged to go to the doctor often. Unfortunately, it also means that some doctors just take the shot gun approach to everything.

I fault the lack of extensive training before becoming full fledged doctor. In the States, that would be at least 10 years with lots of real world experience.

4 ( +5 / -1 )

Doctors are human. You can debate the quality of care in Japan with that in another country, but where you go, the doctors are still human. A doctor sees dozens or a even 100 patients in a day, has a few minutes with each. So they go for the most likely quick diagnosis, prescribe a treatment, and if that doesn't work they might try something else. Most likely the patient gets better on his/her own. He would have gotten better if he just stayed home, but now he attributes his cure to the doctor.

If it's something more serious, it gets worse while the doctor slowly tries one diagnosis after another. Not to blame the doctor, but they have very little time and some maladies can be rather difficult to diagnose.

If something concerns you, by all means see 3 or 4 different doctors. If you are lucky, once of them will give you an accurate diagnosis. To the doctor you are 1 of the 100s of patients he sees, many of them with life and death issues. However you only get one life - so nobody will take your concerns as seriously as you will.

-2 ( +2 / -4 )

NOT SURPRISING AT ALL. japanese doctors' adivs and diagnoses generally suck. standards are really much lower than french doctors for example. i never feel like i can trust jpanese doctors . they will always find you some kind of tumor

0 ( +2 / -2 )

Kind of a joke I thought when I lived there. I did however figure out a relatively foolproof way to get better medical care in Japan: I would call the best hospitals in the area ahead of time and ask for appointments with specialists of whichever discipline I required who'd gone to medical school in the good ol' US of A (thumbs-down magnet for that statement right there).

I once had a very painful rash on the top of my foot and was diagnosed with dry skin by one doctor, "foot herpes" by yet another, and when I went to the US-educated doctor, he correctly identified that I'd been bitten by so-and-so insect and provided medication that remedied the ailment within hours.

1 ( +2 / -1 )

That low?!

-2 ( +0 / -2 )

Get a 2nd 3rd and 4th opinion then mabye you will get to the root of your problem. Never trust any doctor on the first visit.

2 ( +2 / -0 )

A global review article in the British Medical Journal, published in Jun 2013, suggested that delayed or wrong diagnosis rates of 10–50% have been identified in studies of coronary artery disease, HIV-associated complications, tuberculosis and a wide range of malignancies. Japan's 30% rate would appear to be average, though rates do vary across disease groups and countries.

Trigger tools have been developed to assist with the evaluation, measurement and management of diagnostic errors. Insurance companies are interested and adept at this.

Traditionally, autopsy studies, case reviews, surveys of patient and physicians, voluntary reporting systems, using standardised patients, second reviews, diagnostic testing audits and closed claims reviews have been used. Although these different approaches provide important information and unique insights regarding diagnostic errors, each has limitations and none is well suited to establishing the incidence of diagnostic error in actual practice, or the aggregate rate of error and harm. 

Electronic surveillance may be effective in identifying diagnostic errors through discrepancies between laboratory and pharmacy records and discovering diagnostic errors through data mining is probably just around the corner. Although the use of trigger tools will not capture all diagnostic errors, their use will substantially enrich the yield compared with random chart reviews and, thus, bring more errors to attention.

0 ( +0 / -0 )

this should not be surprising considering how ancient the japanese medical industry is especially when it comes to General Physicians. Dinosaur doctors pushing 70 or 80 still run clinics using techniques relegated to antiquity in order to diagnose disease. i don't think i've met many doctors here who use differential diagnosis to narrow down the causes of certain symptoms.

patients in japan are routinely hooked up to IV's for conditions that would never warrant it in most developed countries with modern medical care.

in addition the communication between doctors within the same hospital tends to be nonexistent in japan. a patient who has received a CT scan as requested by one doctor in XYZ department may be referred to a second doctor in another department without the other doctor ever knowing the patient had a CT scan, and the scan data itself of course often does not make it to that new doctor.

the solution is simple, more doctors from japan need to be sent on exchange programs and training seminars conducted overseas. doctors should be required by the medical association or the board to contribute to academic research or publish papers -in english- so that their techniques can be observed (and corrected) by the global medical community. this is quite standard in most western nations.

invasive treatment is far too common in japan and probably results in a large number of needless followup treatments to deal with the ensuing infections and complications.

it is a real shame considering how advanced japanese medical science is when it comes to certain specialized fields including pharmaceuticals, imaging technology etc.

1 ( +1 / -0 )

The biggest problems for me have been a) if the cause of a problem is not what I was worried it was, then no alternatives are offered, nor further investigation to find out a possible cause is offered; and b) options for treatment are not offered, eg surgery or ....? You do have to do their job for them up to a point, and have to take the initiative, be more active in demanding or refusing treatments.

0 ( +0 / -0 )

IN any kind of profession, people should be more careful, doctors are not god. Nor are the wine-makers nor the lawyers nor the trillionares nor U or me. 60% of Japanese doctors are very careful, I cannot say the same

for other countries because they are not god. even god makes mistakes, Look at the world to-day................................................................24th APRIL 2017.

0 ( +0 / -0 )

Gotta wonder if these rates of misdiagnosis relates to all universal health care locations or if it also happens at for-profit health care situations, like in the USA?

I wasn't able to find any hard data, but suspect similar misdiagnosis rates in all 1st-world countries.

0 ( +0 / -0 )

The emergency rooms are particularly bad. Unless you're dying, they just patch you up and send you home.

But the stat is a bit misleading. In some cases, there are two or three possible diagnoses, and part of the process of getting the final diagnosis means evaluating the patient's response to the first treatment.

0 ( +0 / -0 )

Pls try America 's hospitals. Where do anyone live ???. Japan have the best health care. Try Europe, just a cut takes 5 hours to get a doctor in the emergency ward of a big hospital. Pls wake up people.

-1 ( +0 / -1 )

Pls try America 's hospitals. Where do anyone live ???. Japan have the best health care. Try Europe, just a cut takes 5 hours to get a doctor in the emergency ward of a big hospital. Pls wake up people.

Yet American hospitals are more modern that Japanese hospitals. An American hospital is not allowed to turn away an emergency patient for any reason, while in Japan people still die because ambulances drive from emergency room to emergency room, only to be turned away.

And though healthcare in America is not free, there is no firm requirement that you pay. If you show up at an American emergency room with no job, no insurance, and no money, you will still receive full treatment, immediately.

Funniest still is that, though people like you think Japan has the best healthcare, the wealthiest Japanese, Europeans, and Canadians often to to America for treatment.

A quick example. My wife's coworker was diagnosed with stage 3 breast cancer at a Japanese hospital. She had to wait 3 months for surgery. That was 5 years ago, and she is still battling the disease. In America, my mother was diagnosed with stage 3 breast cancer. She received surgery on the same day, and fully recovered. When I told my mother's doctor about my wife's friend waiting 3 months for surgery, he was shocked, he said "cancer can spread a lot in three months." My wife's friend was treated at what is supposed to be Tokyo's best hospital.

1 ( +2 / -1 )

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