Brandy Gunsolus has witnessed diagnostic errors as a patient as well as a professional.
A decade ago, she started experiencing headaches, a rash – and repeated miscarriages. She went to different specialists for two years before one of them realized that the initial test she was given was not broad enough to cover the condition he suspected.
At the same time, she was a laboratory manager for a large medical practice, working closely with a group of family medicine physicians. Her training as a medical laboratory scientist gave her the foundation she needed to do her job well. However, she still experienced challenges:
They would frequently ask me questions about what test they should order for certain conditions or how to interpret a result on an uncommon test. I realized very quickly that I didn’t have the knowledge necessary to answer some of these questions.
Her drive to give doctors the best possible advice led her to pursue a master’s degree in Clinical Laboratory Science, followed by a doctorate that had just been created in that field.
Now, as the first person to complete a DCLS, Dr. Gunsolus is at the forefront of a movement that is expected to reduce diagnostic errors while uniting the clinical laboratory and direct patient care.
Nearly every adult American has been the victim of at least one diagnostic error, according to a 2015 report by the National Academy of Medicine. At least one in seven times a diagnostic error is made, the patient is treated ineffectively as a result, often with severe consequences. A recent study from Johns Hopkins points to medical error – the largest component of which is diagnostic error – as the third leading cause of death in America.
A promising plan to improve the situation involves a unique kind of medical collaboration.
The National Academy of Medicine in the US has endorsed the increased use of expert diagnostic teams in providing two important services to all treating healthcare providers:
- Recommendations for the appropriate tests to evaluate a patient.
- A patient-specific, expert driven interpretation of the test results within the clinical context of the patient.
These expert groups, which unite people from clinical practice and the medical laboratory, are sometimes known as diagnostic management teams, or DMTs. These teams could be key to halting trends in diagnostic error. Leading them, however, requires people who work at the intersection of research and practice – and recognizing laboratory medicine and the people that practice it as a vital component of today’s complex healthcare system.
The complexity of a medical examination and a specific patient’s clinical course means that healthcare analysts had simply not been able to track the number of delayed or misdiagnoses until they recognized the problem and introduced new queries in the review of medical records.