Of doctors, ducks and zebras

When diagnosing patients, doctors frequently fall back on their medical school training to look for the most likely reason certain symptoms present themselves. To most doctors, a cough, watery eyes, a runny nose and a sore throat is most likely to be an indication of a head cold. But among themselves, doctors also call unusual or rare medical conditions zebras, to describe a surprising disease which looks, walks and quacks like a duck in every other way.

As Dr. Michael Aaronson indicates in Common Things Are Common, Except When the Diagnosis Is Rare, is it possible that doctors have difficulty looking beyond the most common causes for an illness? When you are a sick person on the receiving end of one of these shortcut diagnosis, the effects on your health can be devastating.

Why doctors off miss the diagnosis

No two bodies are alike and no two people are alike when it comes to describing their symptoms. One patient may say the skin rash itches considerably, while another will say that same rash causes a burning sensation. Added together with other symptoms that may be present, the doctor will likely try the most common treatment option first. In part, it is a function of their medical training and in part a problem with the way insurance compensates medical professionals.

The truth is, a large majority of times the doctor will be right in the “common” diagnosis and the prescribed treatment will be effective. The zebras are, indeed, quite rare – but they are also very real and doctors shouldn’t miss them by making poor assumptions.

Various treatment options, just in case

In his article, Dr. Aaronson says that medical schools teach doctors to follow Occam’s Razor, which says that the simplest explanation is usually the correct one. Basically, doctors are taught to diagnose one condition and stick with the treatment plan until the diagnosis proves incorrect or the treatment proves ineffective. Ask yourself if you have ever had a doctor prescribe multiple medications to cover two or three various possibilities for a disease? Doing so would potentially break the first rule they are taught in medical school, “First, do no harm.”

But falling back on trite old sayings and slogans is no excuse for missing a diagnosis that can lead to serious medical complications or death. Doctors and medical professionals have a responsibility to look beyond the common and consider the uncommon if symptoms appear out of the ordinary.

The fact that no two people are alike make it all the more imperative to consider the non-obvious answers. When a doctor is only looking for a duck and fails to look for a zebra, it is cause for concern about how serious he or she is taking the patient’s health and may also be cause for a possible medical malpractice claim.