Al Mulley, Chris Trimble, & Glyn Elwyn. (2012). Patients’ preferences matter: Stop the silent misdiagnosis. The King’s Fund. Available from http://www.kingsfund.org.uk/document.rm?id=9561
Many doctors aspire to excellence in diagnosing disease. Far fewer, unfortunately, aspire to the same standards of excellence in diagnosing patients’ preferences for their care. Because doctors are rarely made aware of an erroneous preference diagnosis, it could be called ‘the silent misdiagnosis’. Misdiagnosing patients’ preferences may be less obvious than misdiagnosing disease, but the consequences for the patient can be just as severe.
Patients’ preferences matter: stop the silent misdiagnosis outlines the scale of the problem, showing that:
- when they are well informed, patients make different choices about treatment
- what patients want often differs from what doctors think they want
- there are significant variations in care across geographic regions.
Written by Al Mulley, The King’s Fund’s first international visiting fellow, and colleagues in The Dartmouth Center for Health Care Delivery Science, this paper challenges the NHS to stop the silent misdiagnosis and argues that by doing so it will improve not only the service offered to patients but also the performance of the health system as a whole. The central recommendation is that the NHS must measure and report the incidence of preference misdiagnoses. Also, both doctors and patients will need better tools and information.
Addressing the problem of the silent misdiagnosis will require a co-ordinated effort at all levels of the NHS, including patients, clinicians, commissioners and policy-makers. This paper offers suggestions for how that might be achieved; its findings are timely and relevant to all who have the best interests of the patient at heart.