Patient Informs 3 Doctors About His Symptoms And They Fail To Diagnose Prostate Cancer For Years

Coordinating the care of a patient can actually make the difference between life and death

. The involvement of several physicians in the treatment of the patient includes the possibility that some doctors might have important information that has to be relayed to the patient as well as the other physicians for proper follow up. Without it the patient could very well go on not receiving suitable and needed treatment. If the patient is informed of each doctor's conclusions and the rationale behind those conclusions the at least the patient can reach an informed decision based on his or her level of risk tolerance. It gets more complex, however, when the one doctor who is on the right track ends up not communicating his or her suspicions and the other physicians are not catching the signs and not ordering the appropriate tests.

Consider the following reported case. A number of doctors had a chance to detect the man's prostate cancer while it was still in its early stages. The individual first consulted with his primary care physician, a general practitioner, with complaints of urinary problems at 56 years old age. The family doctor concluded that the problems were not associated with cancer although no testing was done to rule out cancer.

Ten months afterward the individual saw a urologist who did a digital examination on the prostate gland and ordered a PSA blood test. As it turned out this urologist was not covered by the patient's insurance and so the patient went to a second urologist. While the blood test results came in neither the results of the test nor the first urologist's suspicion of cancer and advice that a biopsy be carried out were passed on to the man's PCS or to his second urologist. The second urologist concluded that the examination of the prostate was normal and that there was no indication of cancer.

Therefore the cancer was not detected for two years at which time it had spread beyond the prostate. By that time, the cancer had spread beyond the prostate and was now advanced. Had the cancer been diagnosed when the patient initially informed his physicians that he had urinary problems, when he saw the first urologist, or even when he saw the second urologist, it would not have yet spread and, with treatment, the patient could have had approximately 97 percent likelihood of surviving the cancer. Since the cancer was already advanced , however, the patient was likely to die from the cancer in under 5 years. The law firm that helped the patient revealed that the resulting medical malpractice lawsuit settled for $2.5 Million.

This case thus shows 2 main types of failures. There was the failure on the part of the PCP and the second urologist to not follow the proper screening guidelines. The other error was one in communication. This took place when there was a miscommunication of the findings, suspicions, and recommendations of the urologist who was not approved by the insurance company and the other physicians. While it is impossible to know if the general practitioner or the second urologist would have followed up on results of the PSA test from the first urologist or on that urologist's suspicion and recommendation they at a minimum would have had information and perspective they were missing.

by: Joseph Hernandez

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