How long can you have something undiagnosed before it's negligence?

[Jonette]

Just wondering how much leeway medical professionals have?
As in if you've had something for years, when is anyone going to ever ask the question of the doctor(s) 'Eh, why didn't you notice that?'

Doctors might be negligent if they do not respond appropriately to what the patient presents with (symptoms which show, or which the patient describes)

So if a 50+ patient came in and described a significant change in bowel habit which had been going on for a month, with effortless weightless and increased fatigue, and the doctor did not order bloods, stool sample and a 2week referral, then the might be negligent from the off.

Dealing with a less specific cluster of symptoms might take considerably more time, but that does not mean the doctor is being negligent. What might be obvious with hindsight, is not necessarily so from initial symptoms.

Patients shouidn't be relying on google.

There is no answer to your question.

Something can go undiagnosed for years because the patient hasn't disclosed a vital piece of information, or the patient is not telling the truth, or the diagnosis is so rare that very few doctors ever come across the condition, for example. That is not negligence.

The question is whether the standard of care fell below that expected of a reasonably competent and skilful specialist. So if a condition which any doctor should have diagnosed within 5 minutes goes undiagnosed, that is negligence. However, if the condition is one that most doctors wouldn't be able to diagnose correctly from the information given by the patient, an incorrect diagnosis or a failure to diagnose is not negligence.

Naughty
Ffs. Lyme disease destroys lives. Next you’re going to talk about chronic fatigue perhaps?

I’ve assumed I’ve had just the latter for a very very long time. Been largely bedridden for 8 years. I had a hysterectomy last year. Then another big surgery repair early this year. I had also advanced and and have chronic pain as well as fibromyalgia. My uterus was poisoning me. I was so ill I don’t think I would have lasted much longer or at best would have needed full time care. I believe I still have chronic fatigue as I’m still not very well or well enough to work. I went out last night without weeks of preparation. 🥳🥳🥳 including last night. I’ve been out in the evening 4 times in 8 years. Time will tell on how much I recover and i think I’m going to take some FDA approved drugs through a private British gp / pharmacy. I also had the test for Lyme in case but don’t have it.

DFOD.

Josette
I know what you mean. I went to the gp for heavy period and pain. I was given tranexamic acid and basically told to piss off when that didn’t work. Gynaecology is horrendous in this country. Cue years of no quality of life at all until I demanded to see a gynae privately, which resulted in the diagnosis and a need for an op ASAP.

Well, they're not mind readers. They can only go on what you tell them and I'm not sure a GP can 'guess' what your symptoms are if you are unable to tell them yourself.

The problem lies when you DO give them symptoms and nothing is done. I was classed as a neurotic mother when I insisted that there was something more than I virus wrong with DD. Luckily I insisted on a second opinion, listed exactly the same symptoms and she was diagnosed with Type 1 diabetes.

It is perfectly acceptable for the Dr & patient to work as a team to reach a diagnosis. No doctor can know everything and patients are often experts in their own condition. This does not make the Dr negligent anymore than it makes the patient a specialist professor in their own illness. It an acknowledgement that patients are motivated, intelligent and willing and able to become experts in their specific area

Ben above sums up the situation. One set of symptoms can be interpreted completely differently. Dr 1 wasn’t negligent in his assessment, he diagnosed as he saw fit. Dr 2 looked at the same symptoms differently, and got a different result.

I have a friend who has a number of health problems, which to Google, indicate Lyme's disease or fibromyalgia.
Friend has been suffering various symptoms for a few years (maybe 4), and their GP is treating each thing separately
Friend has MH problems and feels GP is not taking them seriously, but cannot afford private health care to speed up action.
So far, none of the symptoms/issues that have been medicated have improved.

Were you as clear with the doctor as you have been here, OP?

at least 30 years. apparently. that#s how long it took to get a diagnoisis.

I’ve had some worrying symptoms on and off for two years. Lots of tests done, fairly extensive work up, second opinion sought. Nobody seems to have any idea what it was.

Went to see yet another doctor regarding a possibly related symptom. He smiled at me and said “In ten or fifteen years, someone’ll run a test and go so that’s what it is, if only we’d checked that back then”

Some conditions are easier to diagnose than others, some doctors are more clear minded and enquiring than others, sometimes doctors just get lucky with the test they do.

Medicine is frustrating!

This is the nature of (differential) diagnosis, surely? Years ago I saw a (private, incidentally) work GP complaining of tiredness, weight gain, constipation. He immediately wrote out a referral to a gastroentorologist. I then went to my own GP about the same issue, had a blood test done, and was diagnosed as being hypothyroid.

I still wonder about that first GP. Why not order blood tests? Why the immediate referral? But then if I emphasised stomach problems with him and tiredness/weight gain with the other that may have contributed.

I think that finding a decent GP is rare. In my experience you have to have some idea of what might be wrong and be very insistent to have any hope of finding out what's wrong or getting treated.
My sister was going to the doctors for months with unexplained bleeding and bruising, extreme fatigue and a swollen stomach. She kept getting dismissed until she finally insisted on a blood test. She was very ill by the time she was eventually diagnosed with leukaemia. It still makes me angry thinking about it.

@Loveislandaddict. I did actually feel that Dr one was negligent to be honest. DD was three at the time and had lost a lot of weight, dark circles under the eyes, drinking excessively, faint smell of pear drops on her breath - classic symptoms of T1 (as I know now). He point blank refused to test her urine for glucose as 'there's a virus going round', I had even brought a sample to the surgery.

I went straight back into reception and begged to see the other GP at the practice. She immediately listened to me, did the glucose test and called for an ambulance to take us to hospital immediately. DD was in the early stages for DKA at the time.

Everyone in my family has had serious illnesses misdiagnosed. The GP insisted I had constipation when it was hepatitis. Unless it's something very straightforward you don't have a chance.

I had gallbladder pain for 8 years and must have been to the doctors and a&e at least once every 4-6 weeks before they eventually did a scan and rushed me in for an operation to remove it. I kept getting sent away saying "it's heartburn" I'm not stupid but I know what heartburn is and I'm not soft. When the surgeon removed it he came to me post op and said it was incredibly green and infected and was very lucky the infection didn't get into my blood stream. I'd say after 8 years....that's negligence.

Also on another note and it probably happens a lot more often than I thought but I was sent home in active labour in the snow to my home town which is a 20 min drive home only to give birth on my own the second I got home and I had group b strep and they didn't examine me. Strep B is serious and leads to a lot of stillbirth. I'd say that's negligence too

absolutely.
it's not the gp's job to send the patient away with instructions to take 2 paracetamol and come back in 2 weeks

This has made me laugh! Many years ago an oncologist I was working with tried to convince me to do a conversion medical degree and become a gp (I was a scientist). He used to say: being a gp is really easy, most just say to come back in 2 weeks if symptoms have not improved 😂

lou yes, labour/birth is a whole other can of worms and puts the spotlight on how pain is experienced/how much HCPs listen to patients.

I always get the impression (from my gp) that they hate you researching yourself and tend to think you're a hypochondriac.

For all those saying it's the GPs responsibility to elicit the history, if you arrive complaining of being tired and don't mention your chest pain, then no an accurate diagnosis will not be made. The best thing to do is have a succinct and accurate summary, take responsibility for your own bloody health.
Actual Lyme disease is serious, but it is a very fashionable diagnosis that some people want because it is fashionable. Of course fibromyalgia exists but it's overdiagnosed.
Mummy how was your uterus poisoning you???

My ds is currently awaiting surgery to have a kidney removed as he has stage 1 kidney cancer. This was discovered after a scan on the other kidney for kidney stones. The symptoms of kidney cancer are fatigue and blood in the urine. When we saw the consultant he was told it was a slow growing cancer and could have been there for years.

There is no way that a GP would check his kidney earlier as he had no symptoms. Lots of people can be walking around with cancer without being able to tell.

Of course fibromyalgia exists but it's overdiagnosed.
Care you show us how you came to that statement? Because seeing how hard it is to get diagnosed with fibromyalgia, this sounds fishy to say the least....

Patients shouidn't be relying on google.

Last Monday, DS got a deep bite from a family (outdoor) cat in Poland. He rang his GP for advice, who asked if he had symptoms of rabies. He didn’t the same day - they told him to go to A & E, when he got back later that day. He went to A & E, who gave him tetanus and antibiotics. A nurse and doctor refused to accept his argument, he needed rabies vaccinations and he referred them to Public Health England’s risk assessment! He demanded to see a more senior doctor, who agreed he needed the vaccinations, but sent DS away as they didn’t have any!

DS rang 1111, who made an appointment at the Urgent Treatment Centre for him. Again a nurse refused to look at the PH England risk assessment (which considers Poland as high risk for rabies and in the case of a deep bite, recommends 4 vaccinations within a month). Luckily an Indian doctor came out, who had treated rabies in India - he agreed DS needed the vaccinations and rang up Colindale to order them! He then rang up the GP, saying they should have done that, and had wasted the time of A & E, an hour of his time and a day of the patient’s time.

DS said he argued with 2 nurses and 2 doctors that they should look at the PH England risk assessment, because he needed rabies vaccinations and none of them would!

Considering Poland is high risk, what would they have all said if a healthy 31 year old father had died of rabies - because none of them would look for 30 seconds at the NHS own website on rabies, never mind PH England?

My symptoms were I was never out the doctors. Constant low level illness, tonsillitis, chest infections, wounds not healing, colds, coughs, needing antibiotics a lot
I had around 50 blood tests and was told "all normal" and was being treated like I was a hypochondriac and at that point I was starting to feel like one

The locum GP I saw as I was having night sweats went through them all, realised they were all abnormal and I had more bloods which resulted in a call at night to go to hospital straight away. I was relieved something was wrong
I've been under haematology since, when I was diagnosed I was severely neutropenic

Patients shouidn't be relying on google.

Sorry but I’m laughing there. My experience is that, as a patient, you need to be able to be your own advocate. And yes that means doing quite a bit of goggling. Because otherwise, you are likely to not be treated the way you should. It has only got worse.
Last time I went to see my GP, I explain what was happening and ask to be referred to a specific person I had been referred to before. My GP told me that ‘Yes I ought to be able to see them. He could see I had been referred but had no idea of how he could manage to refer me again. So he would investigate and get back to me’.
That was a simple straight forward case with no hesitation.

When you have anything that is more complex, GP are very reluctant now to refer you to a specialist so a lot of things can get missed :(
And yes strange cluster of symptoms can be hard to diagnosed vs a clear set of symptoms screaming cancer (even though if my dad had listened to his GP, his cancer wouod have been missed). But that’s also the job of the GP to direct the patient in the right direction

I don't see how they can TBH without spending much more time with patients than would be usual. Perhaps we should have health check ups like we have dental check ups - or at least automated screening questionnaires once every 6-12 months? And if they flag up a problem then you get an appointment to talk it over.

The problem is if you're not medically trained how do you know if something is normal or not? And surely most people have little niggling things they have got used to, and wouldn't think to mention to a doctor. I know for me on several occasions I've had issues which I haven't thought to tie together - on one occasion, cold symptoms plus UTI and back pain, I didn't realise the UTI had advanced and gone to my kidney. Another issue I have is ADHD but for decades I wouldn't have put together fatigue, anxiety, forgetfulness, disorganisation. Half of it I put down to personality and the other half to lifestyle. And when I rarely go to the doctor's it's about a specific issue, not this random thing that has been bumbling along for years but never seems to be urgent enough to want to discuss.