Table 2

Alterations in history-taking and physical exam, delays and failures in diagnoses

Survey questionAlteration in history-taking
Number of respondents (%)
Alteration in physical exam
Number of respondents (%)
Presence of others caused you to alter or omitn=409n=409
  Yes369 (90.2)230 (56.2)
  No40 (9.8)179 (43.8)
Likelihood when patient in the hallwayn=369n=230
  Never18 (4.9)5 (2.1)
  Rarely65 (17.6)19 (8.3)
  Sometimes197 (53.4)77 (33.5)
  Often75 (20.3)89 (38.7)
  Always14 (3.8)40 (17.4)
Likelihood when someone known to the patient is present(family/friend/acquaintance)n=369n=230
  Never0 (0)6 (2.6)
  Rarely59 (16.0)46 (20.0)
  Sometimes238 (64.5)135 (58.7)
  Often63 (17.0)33 (14.3)
  Always9 (2.5)10 (4.4)
More likely to alter/omit for patient gendern=369n=230
  Male8 (2.2)5 (2.2)
  Female55 (14.9)48 (20.9)
  Neither (gender plays no role)306 (82.9)177 (76.9)
Alteration/omission led to delay or failure to diagnosen=369n=230
  Yes129 (34.9)94 (40.9)
  No240 (65.1)136 (59.1)
If delay, durationn=129n=94
  Minutes54 (41.9)36 (38.3)
  Hours73 (56.6)56 (59.6)
  Days2 (1.5)2 (2.1)
If ‘failure to diagnose’ relation to medical system (may choose more than one response)n=129n=94
 None–no relation14 (10.9)7 (7.5)
   Neurological8 (6.2)7 (7.5)
 Pulmonary4 (3.1)3 (3.2)
  Cardiovascular10 (7.7)4 (4.3)
  Gastroenterological13 (10.1)19 (20.2)
  Genitourinary92 (71.3)68 (72.3)
  Musculoskeletal4 (3.1)10 (10.6)
  Dermatological6 (4.7)25 (26.6)
 Other23 (17.8)5 (5.3)
If ‘failure to diagnose’
relation to psychiatric condition (may choose more than one response)
n=129n=94
 None—no relation82 (63.6)67 (71.3)
 Suicidal ideation or self-harm32 (24.8)15 (15.9)
 Homicidal ideation or harm to others11 (8.5)10 (10.6)
 Auditory or visual hallucination12 (9.3)5 (5.3)
 Delusions11 (8.5)7 (7.5)
 Psychosis11 (8.5)9 (9.6)
 Other4 (3.1)3 (3.2)
If ‘failure to diagnose’
relation to social issue (may choose more than one response)
n=129n=94
 None—no relation34 (26.4)51 (54.3)
 Domestic/intimate partner violence51 (39.5)31 (32.9)
 Child abuse16 (12.4)11 (11.7)
 Human trafficking10 (7.8)7 (7.5)
 Substance abuse60 (46.5)23 (24.5)
 Elder abuse22 (17.1)12 (12.8)
 Other10 (7.8)4 (4.3)