January 8, 2024
It can be a difficult chore to advocate for yourself in the doctor’s office—especially when what you have to say doesn’t carry the weight that it probably should. According to a new study, many doctors place minimal importance on patients’ perspectives during diagnosis—a practice that may need reassessment, reports Study Finds.
The research—conducted by a team from the University of Cambridge and King’s College London—examines how clinicians value different types of evidence when making diagnoses. Surprisingly, only 4% of the doctors surveyed considered patients’ self-assessments as one of the top three valuable sources of evidence, out of 13 types.
Additionally, the study uncovered a gender bias in diagnosis. Female patients were more frequently told that mental factors, such as stress, were causing or worsening their symptoms. Moreover, male clinicians were more likely to suggest that patients were exaggerating their symptoms.
A patient interviewed for the study expressed that feeling disbelieved and disregarded by their doctor created a “very unsafe environment.” This sentiment underscores the need for medical professionals to evolve beyond the outdated “paternalistic” mindset of “doctor knows best” and to start valuing patients’ views.
The study involved over a thousand doctors and patients and focused on neuropsychiatric lupus as an example. It’s a challenging disease to diagnose—and the research assessed how clinicians weigh 13 different types of evidence, including brain scans, observations from family and friends, and patients’ self-assessments. Nearly half of the patients reported that their doctors seldom asked for their disease assessments, although some patients had positive experiences with doctors valuing their opinions.
Most doctors rated their assessments as the highest, despite admitting uncertainty in diagnosing symptoms like headaches, hallucinations, and depression. These “neuropsychiatric” symptoms, often misdiagnosed, can lead to lower quality of life and earlier death.
The study highlights one patient’s experience of feeling “degraded and dehumanized” by their doctor’s disbelief. The patient emphasized the danger of disregarding patients’ expertise on their own bodies.
Prior research shows that a doctor listens to a patient’s concerns for just 11 seconds before cutting them off. The same study also found that only 33% of doctors give their patients adequate time to speak during a visit.
While some medical professionals—especially nurses and psychiatrists—highly value patient opinions, the study suggests a broader need for a shift in approach.
The authors acknowledge that patients might sometimes misinterpret their “No human being is always going to be able to accurately pinpoint the cause of symptoms, and patients and clinicians can both get this wrong,” concludes Dr. Tom Pollak, a senior author of the study. “But combining and valuing both views, especially when the diagnostic tests aren’t advanced enough to always detect these diseases, may reduce misdiagnoses and improve clinician and patient relationships, which in turn leads to more trust and more openness in symptom reporting.”
The findings are published in the journal Rheumatology.
Research contact: @StudyFinds
