Patient specific care is an ongoing challenge in the medical world today as practice overheads grow and providers have less time for each individual. Although proven to be more beneficial in the long run, many physicians are missing opportunities to fully understand patient cases and therefore cannot respond with specific tailored care. Today’s doctor’s offices are full of high expectations and a constant fight for balance between patient care and profit.
The July 2010 issue of Annals of Internal Medicine, published a study headed by Dr. Saul Wiener, a physician at University of Illinois Medical Center in Chicago. The study looked at errors in diagnoses and treatments on account of doctors misunderstanding, or missing altogether, key information from patient information. The study showed that most providers fail to investigate patient context, such as work and home environment.
Contextual data is specifically important in cases where patients are suffering with rare cancer mesothelioma. Mesothelioma is caused by an environmental danger: exposure to asbestos. If inhaled, asbestos fibers can begin a mutative growth process in abdominal cavity lining.
Asbestos exposure is most commonly known as an occupational hazard. In the US such industries as shipbuilding, munitions manufacturing and oil refining have been know to use asbestos components. Construction is also an industry associated with asbestos, as many building materials have contained the toxic chemical since as early as the 1920s.
Mesothelioma is characterized by a long latency period with symptoms demonstrating decades after cancer development begins; unless the patient knew they were exposed to asbestos, they would not know to consider mesothelioma. A few questions about patient work or home history could greatly help providers with proper diagnosis. Unfortunately, mesothelioma is often misdiagnosed as pneumonia or bronchitis, further postponing proper care. Mesothelioma treatments include surgery, radiation therapy and chemotherapy, but there is no cure for mesothelioma.
Dr. Weiner’s study included medical actors posing as patients who were seen by 100 participating doctors. The actor-patients presented bio-medical, red-flag signs and symptoms. The study concluded that 62 – 88% of the time information was missed that would have been key for proper diagnosis and care.
Such a great margin of error in the patient care process denotes a need for change. The President’s Cancer Panel presented a report to President Obama, titled, “Reducing Environmental Cancer Risk — What We Can Do Now.” This report suggested: “physicians and other medical personnel should routinely query patients about their previous and current workplace and home environments as part of the standard medical history.”



