Acknowledging uncertainty in diagnosis can assist patients (and could avoid Medical Negligence claims)

13 January 2020

All of our specialist medical negligence lawyers have heard Clients (who, by definition, are patients or family members of patients who have had unsatisfactory medical outcomes) say that their story wasn’t heard, they were not talked to, or, that they were not involved in the thought process that led to their diagnosis and treatment.

With this in mind I was interested to read the article in the “what your patient is thinking” section of the BMJ by Mark Wong. He contrasted being given a non-specific diagnosis for his severe symptoms that they were “probably caused by stress”, with a second hospital’s approach which was to “openly acknowledge that they were unsure of the actual diagnosis”.  However, this acknowledgement went hand-in-hand with the reassurance that everything would be done to investigate the underlying cause of symptoms. 

Mark Wong writes: “I felt reassured that a team of doctors was working alongside me during my struggle… I was no longer facing this uncertainty alone”.  He goes on to explain how this inclusive approach allowed him to feel empowered and ultimately led to diagnosis and successful treatment.  It is revealing that this patient didn’t need a definitive answer but recognition of symptoms and the impact that those were having (my emphasis).  This was what gave Mark Wong the reassurance that the doctors were doing their best to help. 

The key “what you need to know” section in the article recites:

  • “Sharing uncertainty around a diagnosis or treatment can help provide patients with reassurance”.
  • “Simply acknowledging the patient’s symptoms can help them to feel empowered and supported”.
  • “Uncertainty is best shared by openly acknowledging, recognising, and discussing it with patients.”

From a medical negligence lawyer’s perspective this makes good sense. Unfortunately, I have cases where, even with severe injuries such as head injuries and spinal injuries, acknowledgment of the patient’s experience of symptoms does not seem to be something that has gone into the mix to reach a diagnosis. 

Whilst it is absolutely accurate to say that patients will feel empowered by the approach suggested, my view is that the downside of not adopting the approach is that important, and time critical treatment, can fail to be administered because the patient’s voice is not heard. Sometimes, in the rush to classify, a definitive diagnosis is given inappropriately. For example we often see this in sepsis or meningitis cases where the symptoms are classified as viral and when clinical situation becomes worse a failure to revisit a fixed diagnosis can have catastrophic outcomes.  What I am saying is that an acknowledgment of uncertainty may mean that intelligent questions continue to be asked when a treatment regime does not appear to be delivering the required results.

I urge the providers of medical care to talk to the patient, remember “telling me you don’t know is ok” if it is done in a supportive way. Take the patient with you on the diagnostic journey because it will help with treatment for all the reasons eloquently outlined by Mark Wong plus, in some cases, it might even avoid a medical negligence claim.

Further information

If you would like to discuss a possible clinical negligence claim please contact one of our Medical Negligence & Personal Injury lawyers on 020 7814 1200, or email us at clinnegenquiries@kingsleynapley.co.uk.

About the author

Kate Rohde is a Partner in the Clinical Negligence and Personal Injury department and an experienced specialist in clinical negligence claims of all types, often acting for bereaved families or on behalf of children and adults who have suffered permanent and profound injuries.

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