Alterations in history-taking and physical exam, delays and failures in diagnoses
Survey question | Alteration in history-taking Number of respondents (%) | Alteration in physical exam Number of respondents (%) |
Presence of others caused you to alter or omit | n=409 | n=409 |
Yes | 369 (90.2) | 230 (56.2) |
No | 40 (9.8) | 179 (43.8) |
Likelihood when patient in the hallway | n=369 | n=230 |
Never | 18 (4.9) | 5 (2.1) |
Rarely | 65 (17.6) | 19 (8.3) |
Sometimes | 197 (53.4) | 77 (33.5) |
Often | 75 (20.3) | 89 (38.7) |
Always | 14 (3.8) | 40 (17.4) |
Likelihood when someone known to the patient is present(family/friend/acquaintance) | n=369 | n=230 |
Never | 0 (0) | 6 (2.6) |
Rarely | 59 (16.0) | 46 (20.0) |
Sometimes | 238 (64.5) | 135 (58.7) |
Often | 63 (17.0) | 33 (14.3) |
Always | 9 (2.5) | 10 (4.4) |
More likely to alter/omit for patient gender | n=369 | n=230 |
Male | 8 (2.2) | 5 (2.2) |
Female | 55 (14.9) | 48 (20.9) |
Neither (gender plays no role) | 306 (82.9) | 177 (76.9) |
Alteration/omission led to delay or failure to diagnose | n=369 | n=230 |
Yes | 129 (34.9) | 94 (40.9) |
No | 240 (65.1) | 136 (59.1) |
If delay, duration | n=129 | n=94 |
Minutes | 54 (41.9) | 36 (38.3) |
Hours | 73 (56.6) | 56 (59.6) |
Days | 2 (1.5) | 2 (2.1) |
If ‘failure to diagnose’ relation to medical system (may choose more than one response) | n=129 | n=94 |
None–no relation | 14 (10.9) | 7 (7.5) |
Neurological | 8 (6.2) | 7 (7.5) |
Pulmonary | 4 (3.1) | 3 (3.2) |
Cardiovascular | 10 (7.7) | 4 (4.3) |
Gastroenterological | 13 (10.1) | 19 (20.2) |
Genitourinary | 92 (71.3) | 68 (72.3) |
Musculoskeletal | 4 (3.1) | 10 (10.6) |
Dermatological | 6 (4.7) | 25 (26.6) |
Other | 23 (17.8) | 5 (5.3) |
If ‘failure to diagnose’ relation to psychiatric condition (may choose more than one response) | n=129 | n=94 |
None—no relation | 82 (63.6) | 67 (71.3) |
Suicidal ideation or self-harm | 32 (24.8) | 15 (15.9) |
Homicidal ideation or harm to others | 11 (8.5) | 10 (10.6) |
Auditory or visual hallucination | 12 (9.3) | 5 (5.3) |
Delusions | 11 (8.5) | 7 (7.5) |
Psychosis | 11 (8.5) | 9 (9.6) |
Other | 4 (3.1) | 3 (3.2) |
If ‘failure to diagnose’ relation to social issue (may choose more than one response) | n=129 | n=94 |
None—no relation | 34 (26.4) | 51 (54.3) |
Domestic/intimate partner violence | 51 (39.5) | 31 (32.9) |
Child abuse | 16 (12.4) | 11 (11.7) |
Human trafficking | 10 (7.8) | 7 (7.5) |
Substance abuse | 60 (46.5) | 23 (24.5) |
Elder abuse | 22 (17.1) | 12 (12.8) |
Other | 10 (7.8) | 4 (4.3) |