How Misdiagnosis Is Increasing Healthcare Costs and How MORE Health is Fixing the Problem

June 1, 2022 by Marc Shuman, M.D.

The effects of misdiagnosis go far beyond patient inconvenience. An incorrect diagnosis can be costly financially — but it can also cost lives.

The numbers support this. A recent Johns Hopkins University School of Medicine study documented the extent to which misdiagnosis affects society. The study concluded that up to 80,000 of all American deaths can be attributed to misdiagnosis, adding up to nearly $2 billion in approved malpractice claims over a 10-year period. Patients are most at risk of misdiagnosis within primary care environments, where one-third of all misdiagnosed cases become serious or life-threatening.

I’ve seen this firsthand. An older woman came for a consultation. We discovered that she had a rare, acutely life-threatening disease. Had she been treated correctly, she would have had an excellent chance of survival. Unfortunately, physicians from another institution misdiagnosed her. While we caught the error and initiated appropriate treatment, sadly, we couldn't save her life in the end.

Not all patients whose conditions are misdiagnosed pass away, of course. However, misdiagnosis can result in other dire consequences, including significant morbidity and permanent deleterious effects. Further, if a patient with a chronic condition is misdiagnosed, the patient’s condition can deteriorate over the months or years it takes to remedy the situation. At the same time, the patient may suffer needlessly from the side effects of using the wrong medications.

The Surging Costs of Misdiagnosis in Healthcare

Beyond the personal costs to misdiagnosed individuals, every misdiagnosis contributes to rising healthcare costs overall. Consider the cost of unnecessary X-rays, CT scans, MRIs, lab tests, medications, hospitalizations, and surgery — both for patients and their insurance companies. A single MRI can require an out-of-pocket patient copay of up to $3,500, depending on the reason for the test. Staying in a United States hospital overnight can result in a $2,607 bill, on average. Someone or some entity has to cover the cost of medical care in those situations because those costs don’t just disappear.

One patient I cared for ended up incurring significant costs after receiving the wrong diagnosis. The hospital’s team misdiagnosed his condition, leading him to undergo multiple blood transfusions and costly outpatient procedures. We couldn’t give him his money back, but we were able to correct his diagnosis, which meant he didn’t have to overspend anymore.

To be sure, some patients are fortunate to be covered by health insurance. The insurance may pick up a significant portion of prescriptions, hospitalizations, visits, and related items, but insurance companies are still businesses. As such, they regularly increase their rates. Between 2011 and 2021 alone, employer-sponsored health insurance premiums rose by 47%. The more misdiagnoses that occur, the higher those rates will go.

Of all the problems in the healthcare industry, misdiagnosis is an important one to tackle. It’s also doable. Accurate diagnoses and correctly prescribed treatments will help to temper the rising healthcare costs. Still, it’s important that this challenge be addressed soon. Our population is aging quickly — about one-fifth of people will be age 65 and older by 2040 — and that means the burden on individuals, private insurance, and public insurance like Medicare will only increase.

How to Prevent a Misdiagnosis: MORE Health's Approach

At MORE Health, we do several things to reduce the occurrence of misdiagnosis. Our robust platform was designed to ensure that a patient with a serious illness is getting a second opinion promptly, accurately, and graciously. Some of our strategies for reducing the impact of misdiagnosis include the following:

1. Give patients access to top physicians and researchers.

MORE Health teams up with expert healthcare consultantsfrom the best medical institutions in the U.S. They’re national leaders who set the guidelines for the diagnosis and prescription in the major categories of illness in pediatric and adult patients. They can provide knowledgeable opinions on conditions ranging from cancer and diabetes mellitus to heart disease and neurological disorders.

One patient with arthritis of undetermined origin used our portal to get evaluated after being misdiagnosed by an “expert” in another country. Our expert healthcare consultantcorrected the assessment and prescribed the proper treatment.

2. Provide patients with second opinions — swiftly.

We provide an expert second opinion within five days. This is meaningful, especially for patients in dire circumstances. Our teams reach out directly to patients and get a feel for their problems before issuing any diagnosis.

A patient with a brain tumor requested our services. Her tumor had been treated incorrectly, and ourhealthcare consultant, an international expert on the disease, worked with her treating physician to suggest the correct treatment. Ultimately, the patient improved, and she even switched her care to our consultant.

3. Introduce patients to the latest options.

In some cases, our consultants recommend that patients replace ineffective medications with newer, more effective drugs. These drugs may have been recently approved by the FDA and are therefore unknown to patients. Similarly, the consultants can inform patients’ physicians of the latest advances in diagnostic technology if that will be to their benefit.

Knowing more about the availability of the latest healthcare treatment solutions helps patients feel more comfortable making decisions. It also empowers treating physicians to increase their knowledge and avoid future misdiagnoses.

Healthcare has many moving parts. When one part is broken, as is often the case with misdiagnosis, it creates a ripple effect. With technology, expertise, promise, and pragmatism, our team works to combat misdiagnosis and ensure everyone has the best care possible. To learn more, get in touch today.

About Dr. Marc Shuman

Dr. Shuman is an Emeritus Professor of Medicine at UCSF and has been listed among Top Doctors in America for three decades. Previously, Dr. Shuman was funded by the NIH and the NCI as a Principal Investigator for 30 years.

About MORE Health

MORE Health is a global digital health company known for giving individuals access to the best medical minds in the world when facing a serious illness or diagnosis. Recognized as a leader in cross-border telemedicine, MORE Health delivers virtual Expert Medical Opinions from world-leading specialists by pairing technology and world-class service. Offered as an employee benefit or on an individual self-pay basis, this service is available to groups of any size in the U.S. and abroad. Since 2013, MORE Health has helped patients on six continents and continues its mission to provide patient advocacy to clients and members worldwide—when they need it most.

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