Misdiagnosis​​

One of the most common reasons that patients report no improvement with their medical treatment over time is secondary to either a misdiagnosis or a delay in diagnosis. 

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Researchers from Johns Hopkins Hospital have reported that 40%-80% of chronic pain patients are misdiagnosed (1). Three of the leading causes for misdiagnosis are:

1. Failure to take a thorough history from the patient 

2. Ordering the wrong tests

3. Assuming that a negative radiology test means absence of disease​​

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Misdiagnosis can have serious consequences for patients, including: 

• Delayed treatment

• Denied disability cases

• Emotional distress

• Incorrect treatment

• Increased medical costs

• Life-threatening consequences

• Loss of trust in the healthcare system

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Diagnoses of exclusion:

A diagnosis of exclusion is a process of elimination. One of the most frustrating diagnoses to have is a functional disorder. This means that you have symptoms, but no underlying pathology was found to explain them. This begs the question, what pathologies have been tested for? You have probably had imaging and bloodwork, but were they the right tests to order? Did you have a genetic test? Did you have an electrodiagnostic study? Did your provider believe that the symptoms you reported were real? At minimum, have you heard a doctor say the words "I don't know?" 

 

Fibromyalgia

Most medical experts agree that fibromyalgia syndrome is a distinct medical disease. However, recent reports that studied the two most common methods of diagnosing fibromyalgia have suggested that only 25% of patients with a clinical diagnosis of fibromyalgia would satisfy fibromyalgia criteria, and 75% of criteria‐positive patients do not have a clinical diagnosis of fibromyalgia. 

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Genetic testing

Despite recent medical breakthroughs in testing for genetic causes of disease, genetic testing remains grossly underutilized. The cost of testing is cheaper than you may think, even if denied by insurance. The process of genetic testing is also easier than you may think. Our partners at Invitae have changed dozens of lives from genetic test results. See below for more information.

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Why Spears Pain & Rehab?

Dr Spears scored 98th percentile on the shelf exam for PM&R residents accross the country, both MD and DO programs. This information is not intended to boast or brag, but it is important that a physician knows their stuff. Dr Spears also knows what it's like to tell a doctor symptoms, only for the doctor to ignore, dismiss, or minimize the symptoms reported to the doctor. 

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As we grow as a practice, the most up-to-date information and accurate information will be routinely discussed for ongoing education. The diagnostic workup will be managed at both a practice-level led by Dr Spears structural as well as at the individual patient level.

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References

• Hendler N. Why Chronic Pain Patients are Misdiagnosed 40 to 80% of the Time? J Recent Adv Pain 2016;2(3):94-98​

• Walitt B, Nahin RL, Katz RS, Bergman MJ, Wolfe F. The prevalence and characteristics of fibromyalgia in the 2012 National Health Interview Survey. PLoS One 2015;10:e0138024. 

• Walitt B, Katz RS, Bergman MJ, Wolfe F. Three‐quarters of persons in the US population reporting a clinical diagnosis of fibromyalgia do not satisfy fibromyalgia criteria: the 2012 National Health Interview Survey. PLoS One 2016;11:e0157235.