Study: Minority Patients Significantly More Likely to Receive Misdiagnosis

According to a new study, racial and ethnic minorities disproportionately bear the brunt of medical misdiagnosis. The study illustrates a widespread problem affecting 12 million adults annually in the U.S., underscoring the urgent need for language and cultural inclusivity. 

Research published in JAMA Internal Medicine and BMJ Quality & Safety reveals a grim reality: nearly 1 in 4 hospital patients who suffered harm or died had experienced a diagnostic error, with an estimated 795,000 patients annually dying or becoming permanently disabled due to misdiagnosis. Significantly, racial and ethnic minorities are 20% to 30% more likely to be misdiagnosed.

“That’s significant and inexcusable,” said David Newman-Toker, a professor of neurology at Johns Hopkins School of Medicine and the lead author of the BMJ study.

Researchers call misdiagnosis an urgent public health problem. The study found that rates of misdiagnosis range from 1.5% of heart attacks to 17.5% of strokes and 22.5% of lung cancers.

Underlying Factors Include Language and Culture

The underlying factors contributing to these disparities are complex, with the most significant being language and culture. While access to insurance and quality healthcare facilities also plays a role, the issue is compounded by unconscious biases and the pressure on healthcare professionals, who, under demanding schedules, may resort to hurried and biased decision-making. Moreover, the lack of representation in medical literature, where diseases are predominantly illustrated through the lens of non-Hispanic whites, further impedes accurate diagnosis for patients of color.

“The vast majority of diagnoses can be made by getting to know the patient’s story really well, asking follow-up questions, examining the patient, and ordering basic tests,” said Singh, who is also a researcher at Houston’s Michael E. DeBakey VA Medical Center. When talking to people who’ve been misdiagnosed, “one of the things we hear over and over is, ‘The doctor didn’t listen to me.’”

Maternal mortality for mothers who are racial and ethnic minorities has increased dramatically in recent years. The United States has the highest maternal mortality rate among developed countries. According to the Centers for Disease Control and Prevention, minority mothers are 2.6 times as likely to die as non-Hispanic white moms. More than half of these deaths take place within a year after delivery.

Research shows that minority women with childbirth-related heart failure are typically diagnosed later, said Jennifer Lewey, co-director of the pregnancy and heart disease program at Penn Medicine. That can allow patients to further deteriorate, making them less likely to fully recover and more likely to suffer from weakened hearts for the rest of their lives.

Also according to the study:

• Minority patients suffering from heart attacks are more likely than others to be discharged without diagnosis or treatment.
• Minorities with depression are more likely than others to be misdiagnosed with schizophrenia.
• Minorities are less likely to be diagnosed early with dementia, depriving them of the opportunities to receive treatments that work best in the early stages of the disease.

LanguageLine Can Help

Languageline is proud to play a role in ensuring that all patients receive correct diagnoses. The benefits of working with LanguageLine include:

• Overcoming Language Barriers: Languageline provides professional interpretation services in over 240 languages. This can help ensure clear communication between patients with limited English proficiency and medical professionals. With a qualified interpreter, the patient can accurately describe their symptoms and medical history, while the doctor can explain the diagnosis and treatment options in a way the patient understands.
• Improving Cultural Sensitivity: Languageline interpreters are not just language experts, but are also culturally competent. This means they can help bridge cultural gaps in understanding symptoms and illness presentation. An interpreter can explain medications and treatment plans in a way that is sensitive to the patient's cultural beliefs and practices.
• Reducing Unconscious Bias: Having a qualified interpreter present can help to reduce any unconscious bias. When a patient speaks through an interpreter, the doctor may be less likely to make assumptions and focus more on the presented medical information.