Can doctors be wrong when they say what? Not gods: does a doctor have the right to make a mistake? Urinary tract infections

Staff reductions, budget cuts and increased workload for doctors - all this inevitably leads to the fact that even the most qualified doctor is not able to pay enough attention to each patient. And if you come to the appointment with complaints that can arise from several different diseases, the likelihood of an error increases. The best course of action in this case is to be aware of the risks, ask the right questions and reasonably insist on additional examinations.

1 error

SYMPTOMS: decreased sensitivity (especially if it is felt more strongly on one side), headaches, dizziness, visual disturbances, coordination of movements, slow speech.

Diagnosis: disorders of the vestibular apparatus, migraine, diseases of the inner ear.

What else could it be: stroke.

CAUSE OF ERROR. Up to 25% of strokes in people under 45 years of age are not diagnosed in a timely manner. If the patient seems young and healthy, and the attack is not too extensive and the symptoms are vague, then the doctor, exhausted by a lack of time, may not suspect a stroke and send you home. In this case, you risk experiencing another attack - this time more intense. And besides, if proper treatment is not started in the first three hours after a stroke, the chances of recovery are reduced.

WHAT TO PAY ATTENTION TO. If the decrease in sensitivity is more pronounced on one side (left or right), if you notice several of the listed symptoms, immediately call an ambulance.

2 error

SYMPTOMS: headache, pain and ringing in the ears, back pain, neck pain or toothache.

Diagnosis: migraine, otitis media

What else could it be: dislocation of the jaw.

CAUSE OF ERROR. If you have nagging pain in your head, back or neck, you will most likely see a therapist or neurologist, but in reality the doctor you need is a dentist. The difficulty is that the symptoms are very diverse and can easily be mistaken for manifestations of other diseases. In addition, pain is not always permanent, but can occur periodically over many years. Jaw damage can be caused by trauma, misalignment of teeth, muscle spasms, or even a wide open mouth when yawning. Due to the location of the joint, it is not always easy to determine a jaw dislocation using an x-ray. As a result, some patients suffer from pain for decades.

WHAT TO PAY ATTENTION TO. Medicines prescribed by a doctor, massage, compresses, rest and physiotherapy do not bring relief? To the dentist!

3 error

SYMPTOMS: weakness, difficulty breathing, pain or heaviness in the chest.

Diagnosis: stress, panic attack.

What else could it be: heart attack, myocardial infarction.

REASON FOR ERROR: Firstly, the symptoms of heart disease in men are usually much more pronounced than in women. Often weakness and fatigue are the only complaints of patients, on the basis of which the correct diagnosis is not always made. Secondly, coronary diseases in Russia and throughout the world are rapidly becoming younger; problems these days arise even in women under 40 years of age. The risk increases due to excess weight, hypertension, smoking, and taking certain hormonal medications.

WHAT TO PAY ATTENTION TO. If the treatment prescribed by your doctor does not help and you do not feel better within 24 hours, immediately consult a cardiologist.

4 error

SYMPTOMS: weakness, apathy, weight gain, insomnia, muscle pain.

Depression.

What else could it be: hypothyroidism

CAUSE OF ERROR. If your main complaints are weakness and bad mood, the doctor will automatically associate these symptoms with depression and refer you to a consultation with a psychotherapist. But in combination with a sharp change in weight and muscle pain, weakness and apathy may indicate a malfunction of the thyroid gland, which does not produce enough hormones. Without timely treatment, this failure can lead to hypertension, high cholesterol, heart disease and real clinical depression.

WHAT TO PAY ATTENTION TO. If everything in life is quite good, but weakness and melancholy have become your faithful companions, the first time you see a doctor, ask for a referral for a blood test to check your thyroid hormones.

3 more popular mistakes in diagnoses

5 error

SYMPTOMS: abdominal pain, flatulence, problem skin, constipation or diarrhea.

Diagnosis: intestinal dysbiosis.

What else could it be: irritable bowel syndrome, lactose intolerance, diseases of the stomach and duodenum, colitis.

CAUSE OF ERROR. If you complain of abdominal pain, the doctor gives a referral for bacterial culture; the test usually shows deviations from the norm. The patient is prescribed enzymes, antibiotics and probiotics. But such treatment is largely ineffective, because an imbalance of microorganisms in the intestines is not a disease, but a consequence of a number of disorders. And they must be eliminated. Intestinal dysbiosis is simply not included in the world classification of diseases. And the flora in the intestines, on the basis of which the diagnosis is made, changes depending on nutrition, medication and is a situational indicator.

WHAT TO PAY ATTENTION TO. When you see a diagnosis of “dysbacteriosis” in the chart, insist on finding the cause of the disorders.

6 error

SYMPTOMS: weakness, pressure surges, dizziness, headache, sleep disturbances.

Diagnosis: vegetative-vascular dystonia.

What else could it be: high cholesterol, intoxication of the body (for example, against the background of tonsillitis or chronic diseases of the gastrointestinal tract, kidneys).

CAUSE OF ERROR. Vegetovascular dystonia is another common diagnosis in Russia, which does not exist in the international classification of diseases. In fact, the blood vessels are just a target, and the breakdowns in the body that caused the deterioration of their condition need to be corrected. Usually the doctor prescribes a course of vascular medications, which do not give the desired result. Because if the cause is high cholesterol, therapy is needed to improve liver function and diet and quality of nutrition. And if the body is intoxicated (say, there is tonsillitis or chronic diseases of the gastrointestinal tract, kidneys), then it is necessary to get rid of foci of infection.

WHAT TO PAY ATTENTION TO. The reason for feeling unwell. Insist that vascular problems are just a consequence of other disorders that need to be detected and targeted.

7 error

SYMPTOM: backache.

The diagnosis made by the doctor: osteochondrosis.

What else could it be: diseases of the lungs, heart, kidneys, liver, stomach, intestines.

CAUSE OF ERROR. Osteochondrosis is often confused with the pain syndrome of other diseases. A quick and accurate way to confirm or refute suspicions is an MRI examination of the painful segment of the spine. But in conditions of total saving of time and money, doctors often neglect additional examinations. But in fact, pain can be caused by disorders that have nothing to do with the spine.

WHAT TO PAY ATTENTION TO. If after treatment for osteochondrosis the pain does not go away, request additional examinations.

“My first and, perhaps, most striking mistakes were at university. After my third year, I got a job as a nurse. They hired me without even testing my skills. I needed to put an IV on an elderly cancer patient - it seemed that if you touched him, he would crumble. I have never injected into a vein: neither on a simulator, nor on a strong person. And they just told me: “Go and do it. We all started this way, and you will learn through practice,” - no one was sent with me. After my attempts, the patient had huge hematomas on both arms, and there was simply no way to place an IV. They scolded me and said: “Why are you so armless? Go away." And I didn’t even see what they did then. Since then I have never injected into a vein. I am a doctor with eight years of experience, and this is shameful.

Of course, this is primarily a problem of the education system. I thought: I was being taught everything I needed, and I studied well. But, as it turned out, if you don’t have the opportunity to attend various clubs at the university, you find yourself completely unprepared. Senior colleagues did not support me or help me when I performed the manipulation for the first time. It turns out that what happened is not the fault of any one person, it is a complex responsibility. However, it is difficult not to blame yourself: you hurt someone with your own hands. As a result, I deliberately began to work in an area where there was a minimum of practical things.

When I started working as a pediatrician, my mistakes became due to a lack of knowledge. For example, at my appointment I had a child with fever of unknown origin who had not been vaccinated against pneumococcal infection. According to international standards, he should receive a dose of the antibiotic ceftriaxone, since there is a possibility of blood contamination by bacteria. I didn't prescribe it because I didn't know if it was a strict recommendation. When the child and his parents left, I decided to clarify and saw that ceftriaxone must be given. I called them and explained everything.

I always admit my mistakes and have never regretted it. It seems to me that it’s normal if the doctor doesn’t know something: the amount of information is huge, and it is constantly updated. But at the same time, of course, the doctor must protect himself as much as possible from mistakes: check recommendations, manuals, etc. The only trouble is that in Russia such practice is not an obligation, but the initiative of the doctor. Our doctor is not required to keep abreast of new medical advances. That is, even if a doctor could not diagnose cancer for a year because he did not order some basic analysis, there is no way to prove that the doctor is wrong: there is no fulcrum, no standards. I was once at a review of a fatal case at the city health department after a complaint from the relatives of the deceased patient. The level of discussion there was amazing. The head of the commission apparently worked as a doctor for a very short time. And she explained to the doctor who was the subject of the complaint what he should have done. Needless to say, these recommendations were more harmful than useful.

If all doctors start telling patients honestly about their mistakes, I think patients will start a revolution. And maybe it won't be so bad. For example, I can’t imagine normal practice in today’s working conditions in a clinic. If the local physician does not notice serious changes in the test results, then how can he make a claim? He does not have time to fully understand each case. He can probably say at the beginning of each appointment: “We have 12 minutes, 5 of which I will fill out documents, so don’t expect much. I will try to do my best, but our conditions are not normal, and I will make mistakes.” But who would dare to say that?

M. G., neurologist

“Many years ago, my patient was a very sweet old lady of about 80. This woman had episodes of disorientation that reminded me of a transient ischemic attack. I treated her in accordance with my then ideas about what should be done in such cases: I gave her metabolic drugs, tried to treat her slight hypertension and gave aspirin, but the episodes were repeated. In addition, this old lady had atrial fibrillation, which I knew about. This condition is accompanied by a very high risk of stroke, which with proper treatment can be prevented by prescribing drugs that reduce blood clotting. I didn't do this. I think because of the gap in education. The case ended sadly: the old woman had a stroke and died. She had a husband with senile dementia, who, of course, survived only because she looked after him. I don’t know what happened to him next. I remember them often.

I blamed myself, but not to such an extent that I went on a drinking binge or to draw far-reaching conclusions There was also a case when I was in residency: a woman came into “my” ward with pain. The ambulance thought she had osteochondrosis and took her to the neurological department. I realized that the matter was different, and besides, our manager said that it was rheumatoid arthritis: everything was serious, and the patient urgently needed to be transferred to the therapeutic department. Well, I thought: “Arthritis and arthritis - what’s the big deal?” It was on Friday, I decided that I would do this on Monday, because it is quite difficult to transfer a person to another department in a regular hospital. He prescribed some treatment. Over the weekend, the patient developed disseminated intravascular coagulation (DIC) and died. It is likely that she could have been saved in the therapeutic department, where they have experience in treating such patients.

Of course, I blamed myself, but not to the point of going on a drinking binge or making far-reaching conclusions about my own qualifications. This is a work situation, and time heals - gradually you stop worrying so much about it.

I understand perfectly why patients and their relatives want any doctor’s mistake to become public knowledge. They think that if this does not happen, then the doctor can get away with everything. Not really. Doctors are worried - we shouldn’t think that our conscience doesn’t torment us. The boss scolds us, the doctor does not go unpunished. You just can't wash dirty linen in public In addition, patients or relatives may think that doctors are “covering up” for an incompetent colleague, when in fact, they are hiding a mistake that arose for objective reasons.

It seems to me that the fact that relatives are not told about mistakes is normal in our conditions: a doctor should not go to jail for this. To change the situation, it is necessary to transfer the issue of medical error from the criminal plane to the economic one. Relatives or the patient must receive compensation, for which the doctor, of course, must have insurance, but in Russia this, unfortunately, is not at all common. It is clear that the doctor should not go unpunished, but let this be a matter for the professional community, not a criminal court. You should be deprived of your license - at the most. I assure you: if instead of the threat of prison there was a threat to stop being a doctor, the doctors would not relax. No matter what anyone says, none of the doctors want to change their profession.

Of course, I would like for errors to be analyzed within the medical association, so that we can calmly talk and more experienced colleagues explain how I can avoid such mistakes in the future. This should not be discussed in the press: in fact, medical error is not news, it happens every day.

But, of course, when I say all this, I do not mean cases of negligence. When a person with a heart attack is brought to the hospital, and he waits another two hours for help because the doctor is drinking with colleagues, this is not a mistake, this is negligence. There are criminal penalties for it, and rightly so.”

M.E., oncologist

“As long as you work as a doctor, you will make mistakes. If you don't want to make mistakes, it's better not to go into medicine. I understood this from the very beginning. Most medical errors are associated not so much with negligence or irresponsibility, but with a lack of knowledge, poor organization of work, or even a lack of will. There is such a method of treating infections that have arisen against the background of a serious illness: transfusion of granulocytes (blood cells), but in 10 percent of cases the person dies from this treatment itself. When one of my patients had such a severe infection, senior colleagues felt that a granulocyte transfusion was necessary. I was against it, but apparently I didn’t have the will to push through this decision. The transfusion was performed - the patient died. Of course, before the procedure we explained to him the risks, but in such a situation you cannot say: “Ivan Ivanovich is for this procedure, but I am against it” - you come with a consolidated decision. Otherwise, it is very difficult for a person to find support and make a choice.

There is not a single doctor who has never made a mistake in the dose or speed of administration of the drug. This is especially true for oncologists, when the course of chemotherapy consists of many specific drugs. When using a complex formula on a calculator, you may press the wrong number and get the wrong dose. And then it happens that a nurse saves your life: if she understands that she never administered 3 ampoules per 20 kg, she will tell you about it. But you shouldn't count on it. There was a case in my department when for some reason the doctor wrote that potassium should be administered not for several hours, but for 20 minutes. An inexperienced nurse was caught and the child died. But in a good way, of course, it is not the nurse who should insure. It has been established that the introduction of computer prescriptions reduces mortality in hospitals by 20%, because the program simply will not allow you to exceed the dose.

There are mistakes due to inattention, due to the mistakes of others. Recently, a patient came to see me, who a year ago was diagnosed with breast cancer without metastases, since the lymph nodes were not enlarged on ultrasound. But during the operation, a biopsy of the node was performed, and it turned out that there were cancer cells. In the extract, the stage was not changed. And then the patient comes, in her report it is written in small letters that metastases were found, but in the extract it is completely different. I didn’t notice this, or she didn’t bring this piece of paper at all - in general, we didn’t treat her the way we should have, and she had a relapse.

If the mistake is obvious, then you have no choice but to admit it and apologize. Of course, no one wants to go to prison, and if a fatal mistake is made, then the natural desire of any doctor is for the patient’s relatives not to find out about it. But medicine is not unique in this sense. If in a restaurant the cook did not wash his hands after using the toilet, no one will tell you about it - you will only find out if you have diarrhea. If you are trying to hide a mistake, and your relatives suspect something, then you need to tell them everything. At least because the further you hide, the more mistrust, suspicion and desire they have to punish you.

Of course, any mistake hurts. But you don’t have the right to come to your senses for a long time. You have patients every day. A doctor must be able to survive his mistakes - this is as much a part of professionalism as the ability to properly wash his hands and conduct an examination.
To change the situation systematically, you first need to admit that all doctors make mistakes To change the situation systematically, you first need to admit that all doctors make mistakes. In the West, they have switched to open publication of their mistakes, and naturally, hospitals are striving to reduce their number. Now you understand that in this department there are 2 hospital infections for every 10 hospitalizations, which is more than the norm. You start to figure it out: yeah, the nurse doesn’t use disposable rags - why? Because the rags are huge and she is uncomfortable. Or here’s a common mistake: saline and potassium are in very similar ampoules, and of course they are confused, and this is deadly. Therefore, in the West, ampoules are painted in different colors. That is, often it is not so much education that is important, but a systemic reduction in elementary errors: you need to schedule routine processes, purchase multi-colored ampoules, buy comfortable doormats, and then fewer patients will die.”

A. N., neurosurgeon

“In the first year of residency, I performed a blockade on a patient: after spinal surgery, she complained of back pain. I inserted the needle and did not pull the syringe plunger towards myself to understand where I was. It seemed to me that I was in a muscle that was in spasm and hurt. I injected 20 cubes of a long-acting anesthetic - after a few seconds the patient’s legs became paralyzed, and a second later her stomach. I pulled the piston towards myself and saw the cerebrospinal fluid: I injected the anesthetic directly into the subarachnoid space (the cavity between the membranes of the spinal cord - editor's note), and it rushed to the head. I quickly wheeled the patient to the intensive care unit, and on the way, first her chest, then her arms, and then her tongue became unconscious. When she was intubated in the intensive care unit (a tube was inserted into the larynx to restore breathing - editor's note) and the danger had passed, I was completely wet: I was afraid that I had killed the patient. When the anesthetic wore off and she came to, I honestly told her that I had made a mistake. She had absolutely no complaints: “Well, it happens.”

Doctors who take mistakes too seriously are unsuitable for their profession: they refuse operations, start drinking, snorting cocaine

Doctors are incredibly smart, but sometimes they make mistakes. There are diseases that are fairly easy to diagnose, but others can be a serious problem. In addition, the doctor usually has only a limited time to listen to the patient and determine what kind of disease he has. It is not surprising that one cannot expect precision from this process. Study this list to find out which diagnoses doctors most often have difficulty with.

Acute renal failure

According to statistics, this condition is the most common mistake made by doctors. Kidney damage develops gradually over the years, so many people don't even realize there's anything wrong with them. In addition, often the problem does not manifest itself through any symptoms. If they do appear, most often it is swelling, decreased urination, shortness of breath and drowsiness. There are also cases when the state of the body seems normal, while the kidneys suffer greatly - not every doctor is able to establish this.

Lyme disease

This bacterial disease causes muscle and joint pain and fatigue. It develops due to a tick bite and is most often diagnosed by the appearance of a rash. However, some people do not have a characteristic rash. Because of this, such patients can remain without a correct diagnosis for more than a year, all the while suffering from severe symptoms.

Fibromyalgia

If you've been suffering from chronic discomfort for a long time, but your doctor can't figure out what's causing it, there's a high chance you'll be diagnosed with fibromyalgia. This is a condition that results in muscle pain. However, fibromyalgia is often not the issue. According to statistics, two thirds of people with this diagnosis receive it incorrectly.

Internal bleeding

Bleeding can occur in the stomach, esophagus, intestines, and small intestine. It is incredibly difficult to diagnose because the first symptoms are weakness and dizziness associated with low blood pressure and rapid heartbeat. Many people end up in the hospital with the same symptoms. If not diagnosed correctly, it can be very dangerous.

Celiac disease

Celiac disease used to be very rare, but now this chronic autoimmune disease is becoming more common. It manifests itself when a person consumes gluten - this substance causes an immune response leading to diarrhea, bloating, gas, and fatigue. However, sometimes the disease does not manifest itself at all. Because of this, people are often misdiagnosed. Not every doctor carefully checks whether a person actually has gluten sensitivity.

Lupus

Lupus is a chronic autoimmune disease in which the immune system attacks healthy cells. It can affect joints and skin, as well as the brain, lungs and kidneys. At the same time, thousands of people are misdiagnosed. More than half are told that their symptoms are psychological and that there is nothing wrong with their body. Studies have shown that it sometimes takes six years to get a correct diagnosis. Because of this, the body can suffer greatly.

Heart attack

There is a stereotype that a heart attack can be easily recognized, but this is not always the case. According to experts, sometimes the condition causes mild symptoms - chest pain, shortness of breath, sweating, dizziness. In addition, pain in the back and jaw, as well as vomiting, may sometimes occur. This causes doctors to confuse a heart attack with heartburn, a gallbladder infection, or a pulmonary blood clot.

Urinary tract infections

Urinary tract infections are extremely common, yet they are often misdiagnosed. According to research, less than half of women diagnosed with a urinary tract infection actually suffer from such a problem. Doctors often don't see the whole picture, which can lead them to miss the possibility that the problem is a sexually transmitted disease.

Rheumatoid arthritis

Rheumatoid arthritis usually causes painful swelling in the joints, most commonly in the hands. Unfortunately, it is very difficult to obtain a correct diagnosis at an early stage of the disease. There are so many other diseases with the same signs and symptoms, there is no clear test to determine whether it is rheumatoid arthritis. Additionally, some people show no obvious symptoms at all.

Ear infections

Ear infections are easy to diagnose, right? No, sometimes this can be a problem. Often the diagnosis is made incorrectly, children simply complain of pain in the ears and are immediately given an antibiotic. In fact, the symptoms should have been studied in more detail. However, doctors prefer to prescribe antibiotics, which sometimes leads to problems such as diarrhea, nausea and allergic reactions.

Depression

This is a condition that is often associated with misdiagnosis: patients are assured that there is nothing wrong with them, or, on the contrary, people without depression are prescribed antidepressants. Statistics show that depression is correctly diagnosed in only 47 percent of cases. This means many people don't get the help they need or believe they have a disease that they don't.

Irritable bowel syndrome

Irritable bowel syndrome is associated with a range of symptoms, such as colic, abdominal pain, bloating, diarrhea or constipation. This makes it very difficult to diagnose this condition. Research has shown that one in ten people diagnosed actually suffer from something else, such as Crohn's disease or ulcerative colitis.

Aspergillosis

You may have never heard of this disease. This is an infection caused by mold that affects the respiratory system and causes an allergic reaction or lung disease. Symptoms such as cough, fever, chest pain, chills, headache, shortness of breath often lead doctors to think that the cause is asthma or tuberculosis. Without appropriate treatment, the condition can be fatal.

Cancer

According to scientists, cancer is one of the diseases that very often does not receive correct diagnosis. The most commonly misdiagnosed diseases are lymphoma, sarcoma, melanoma and breast cancer. The thing is that there are a huge number of signs and symptoms, there is little information, genetic factors may not be accurate. Because of this, cancer can go undetected until it becomes difficult to treat.

Migraine

Migraine is a complex and poorly understood problem, so the diagnosis is often erroneous. People often think of headaches as migraines, but this condition is much more serious and can cause vision loss and other symptoms. However, migraine manifests itself differently in all people, which complicates diagnosis.

Pulmonary embolism

When a patient comes to the doctor with chest pain, shortness of breath and cough, it can be difficult to determine the cause of the condition. Embolism is confused with asthma, pneumonia, bronchitis, and sometimes even a heart attack. In fact, the cause is a blood clot, which can be fatal.

Stroke

A stroke requires prompt medical intervention. However, sometimes dizziness is thought to be related to inner ear disease.

Senile dementia

Alzheimer's disease is more common, so some doctors don't try to determine whether there is a connection with other types of dementia. Because of this, the diagnosis turns out to be incorrect.

Pneumonia

Pneumonia is a very serious disease that makes breathing difficult. Doctors often confuse the disease with asthma or tuberculosis.

Decompensated heart failure

This condition occurs when changes in the heart prevent normal blood circulation. It is accompanied by shortness of breath. Often doctors cannot correctly determine the presence of such a disease.

The doctor’s diagnosis is frightening with its ambiguity, the list of medications he prescribed is almost a chronicle, and the thought begins to creep in: maybe the doctor wants to make money on me, or maybe he made a mistake and isn’t healing me? Many people have faced this situation. And in the current crisis, the wrong diagnoses and treatment regimens are a blow to the wallet, not to mention the loss of health, which no amount of money can buy. To summarize, we can say that There are three reasons for misdiagnosis.
The first is the lack of an individual approach to the patient, the need for which has been discouraged by our healthcare system for years.
The second is the doctor’s reluctance to develop when he manages to make a diagnosis that is not even in the modern world classification of diseases.
The third is deliberate false diagnosis for the purpose of enrichment.

[My addition: An honest timekeeping study showed that in an 8-hour working day, a doctor can provide quality consultation to only 12 patients. (45 minutes per patient).
]

“Moreover, if previously it was believed that private clinics were promoting patients for money with false diagnoses, and government agencies were not, today it is even difficult to say who is more honest towards the patient: government agencies, which have turned into private hospitals of individual chief doctors (where contributions to charitable foundations that enrich the heads of state clinics), or private clinics that increasingly comply with European standards and protocols for examination and treatment, pay taxes to the state and introduce advanced methods for treatment,” Sergei Baksheev, obstetrician-gynecologist, medical lawyer, Ph.D., shares his observations. m.n.

It is difficult for a person without medical education to understand whether the doctor made a mistake. What should the patient do? Experts advise practice Second opinion, that is, a “second opinion” on the problem. “And sometimes a third and a fourth,” advises Sergei Baksheev. “Then the chance that you will find a doctor or doctors with an alternative point of view on this diagnosis and its treatment increases significantly ".

But to make it easier to recognize the pitfalls when going to the doctor, with the help of experts it is necessary to understand the typical mistakes when diagnosing the most common diseases and their treatment regimens. So.

GYNECOLOGY

Ovarian cyst: cutting cannot be observed. Where should I put the comma?
“Many doctors like to put a comma after the first verb. While an ovarian cyst up to three cm in size, first diagnosed on an ultrasound, is not always an indication for surgery,” says obstetrician-gynecologist Sergei Baksheev. “After all, the word “cyst”, although it sounds scary , is often a natural formation when the follicle with the egg does not burst in the middle of the cycle (ovulation does not occur) or hemorrhage occurs in the wall of the follicle, which also naturally and spontaneously disappears during menstruation or after 2-3 cycles.At this time, you just need to look after the cyst Monitor with ultrasound."

Mycoplasma & ureaplasma: a way to siphon money from future parents
“Mycoplasma and ureaplasma infections do not affect the likelihood of conceiving and carrying a child. Therefore, their treatment is a commercial area among doctors from the countries of the former USSR,” says Sergei Baksheev. “For couples planning a child, there is a clear examination algorithm that does not include the diagnosis of these infections even in case of infertility. Because these infections do not cause it. But some doctors persistently look for them and treat them, increasing the time of searching for the real cause of infertility."

Flushing the fallopian tubes: recognized as a wrong tactic in Europe
“Obstruction of the fallopian tubes is, of course, an obstacle to the onset of a natural pregnancy. But reconstruction (plastic surgery) of the tubes and their flushing are erroneous tactics and are not used in Europe, since this increases the risk of ectopic pregnancy. Moreover, the number of cases where treatment was ineffective is disproportionate to single percentage of pregnancies, says Baksheev. Therefore, an honest doctor immediately warns about this, and does not put the patient on the operating table. And if she has hydrosalpinx (fluid in the tubes), he also does not mislead with fairy tales about purging, but explains, that in this case it is better to remove the tube, since it, being a source of chronic infection, will prevent pregnancy even with the use of reproductive technologies."

UROLOGY

Urolithiasis: it is often necessary to treat the thyroid gland, not the kidneys
“When oxalates, phosphates, carbonates, and urates are found in a patient’s urine, they are often diagnosed with urolithiasis. Especially if the patient also complains of periodic pain in the lumbar region. But, firstly, the concepts of “stones”, “sand” “There is no such thing in world medicine, there is a “urinary salt diathesis,” says Nikolai Kvach, a urologist at the central clinic of the Podolsk district of the capital, a member of the European Association of Urologists. “Secondly, it can be diagnosed only after detection of bright light inclusions in the kidneys during an ultrasound scan, which is often not carried out. In other cases, salt sediment in the urine is the norm: after all, the function of the kidneys is precisely to remove salts from the body. Therefore, even a slight increase in them can only be situational, and the pain can be neurological in nature.

Another point: we consider the kidneys to be responsible for the development of salt diathesis, while its frequent cause is disturbances in the functioning of the thyroid and parathyroid glands. You don’t have to be a doctor to guess what the consequences of untreated endocrinological disorders will be. And what “effect” will the blind and standard prescription of diuretics and anti-inflammatory drugs have in this case?”

Impotence: they like to pump them with hormones, although in 80% this is a vascular problem
“Such a diagnosis hurts the ears and drives patients into even greater anxiety. But this is of no use, since one of the causes of erectile dysfunction (this is how the diagnosis sounds in world medicine) is precisely psychological problems,” says urologist Nikolai Kvach. “In addition, , we like to treat impotence most often with hormones and anti-infective drugs, while erectile dysfunction is in fact always a symptom of some other disorder, and 80% of cases are diseases of the vascular system.To verify this, it is necessary to conduct a Doppler scan genital organ, which is most often not done.”

CARDIOLOGY

Myocardial infarction: without coronary angiography the diagnosis is invalid
“When there is no clear clinical picture of a heart attack (the pain was easily relieved with nitroglycerin, the person is conscious), then suspicions of myocardial infarction can be confirmed or refuted only by performing coronary angiography - a contrast x-ray study that allows you to see the condition of the heart vessels,” says Yulia Sharupich, a cardiologist of the highest category KNP "CDTs Shevchenko district of the capital". - As a rule, they are limited to detecting characteristic changes on the ECG and an increase in the level of troponin in the blood. But this protein is a marker not only of a heart attack, but also of acute myocarditis, which develops as a result of a viral infection. And in the latter case "In addition to blood-thinning therapy, it is recommended to take non-steroidal anti-inflammatory drugs. If this is not done and myocardial infarction is falsely treated, chronic heart failure will develop."

Cardiac ischemia: treatment with a false diagnosis is fraught with problems with the gastrointestinal tract
“In 50% of cases, the diagnosis of cardiac ischemia turns out to be erroneous,” says cardiologist Yulia Sharupich. “It is possible to assert that there is damage to the coronary vessels, that is, coronary heart disease (CHD), only after performing a bicycle ergometry or treadmill test (studies during physical exercise) . If the results are normal, then this is not ischemia. But we often give this diagnosis to people who have hypertension and complain of discomfort in the heart area automatically. Of course, situations where both diseases are present are not uncommon. But still, the presence of a vascular disease does not mean that there is ischemia. And the consequences of an error are serious. After all, in case of ischemia, several drugs are prescribed at once, for life. And this increases the risk of drug allergies. In addition, the therapy includes lifelong use of aspirin. It increases the risk of bleeding and gastritis, also Its long-term use can provoke an allergy to the entire non-steroidal group (ibuprofen, diclofenac).In case of IHD, these risks are justified - they are the lesser evil. What if there is no IHD?

GASTROENTEROLOGY

Intestinal dysbiosis: a consequence, not a disease
“Pain in the abdomen, flatulence, problem skin, constipation or diarrhea - and the doctor makes a diagnosis: intestinal dysbiosis. At the same time, he directs the patient to a fecal culture, which actually reveals deviations from the norm. The patient is prescribed enzymes, antibiotics and probiotics. Meanwhile "such therapy is largely ineffective. After all, an imbalance of microorganisms in the intestines is not a disease, it is a consequence of a number of disorders. And they must be eliminated," says Natalia Gordienko, gastroenterologist, therapist at the Aximed clinic. "Most often it is irritable bowel syndrome, lactose insufficiency, diseases of the stomach and duodenum, various variants of colitis, sometimes - giardiasis, celiac disease or bacterial overgrowth. In general, intestinal dysbiosis is not included in the world classification of diseases in principle. And bacteriological examination of stool, which is used to diagnose dysbiosis in us, is not always possible to be the only and accurate diagnostic criterion, since the flora in the feces and in the intestines is not the same thing, and, importantly, it changes depending on nutrition, medication and is a situational indicator. Not to mention the fact that fecal microflora standards are not standardized, and different laboratories may have completely different results."

Chronic cholecystitis: bacteria are often to blame for its development
“When changes in the shape and size of the gallbladder are seen on an ultrasound, very often in the conclusion they write: signs of chronic cholecystitis. And if the patient has a history of biliary dyskinesia, then the presence of cholecystitis cannot be doubted. But this is an unprofessional formulation of the question, although often encountered, says gastroenterologist Natalia Gordienko. “After all, although dyskinesia can provoke inflammation of the gallbladder, it cannot be said that these diseases are always an equal sign. In addition, changes in the shape and size of the bladder can be a consequence of abuse of fatty, spicy foods, irregular nutrition. That is, it is enough to even out the diet, and not swallow pills. Or it can even be an individual feature or appear with age. We can definitely talk about cholecystitis only in one case: there are characteristic changes in the results of general and biochemical blood tests. But there are also Another, no less common, mistake in diagnosing cholecystitis is when the liver or bile ducts are blamed for its development. The patient is prescribed widely advertised hepatoprotectors, choleretic drugs and antispasmodics. Meanwhile, cholecystitis is a consequence of other diseases. For example, the gastrointestinal tract, endocrine and autonomic disorders, chronic inflammation in other organs (bacteria from them enter the bile flow of blood and lymph). There will be no harm from such therapy. But also the desired effect.

NEUROLOGY

VSD: an excuse when there is no desire to look for the cause of ailments
“Vegetovascular dystonia is a diagnosis that does not exist in the international classification of diseases; in our country it is one of the most common,” says Vitalina Radetskaya, a neurologist of the highest category at the Center for Shock Wave and Restorative Therapy. “Moreover, in our country VSD is considered the cause of a whole galaxy of disorders: from poor health, pressure surges and headaches to sleep disturbances and panic attacks. Although, in fact, the blood vessels are just a target, and those breakdowns in the body that caused the deterioration of their condition need to be corrected. But since the key word in the diagnosis is " vessels", then the practice has been going on for a long time to prescribe a course of vascular drugs to a VSD patient, which, of course, do not give the desired result. Because if the reason is high cholesterol levels, then therapy is needed to improve the functioning of the liver and the regime and quality of nutrition. And if - in intoxication of the body (say, there is tonsillitis or chronic diseases of the gastrointestinal tract, kidneys), then it is necessary to sanitize the foci of infection.And only then a course of neurological treatment is carried out. If the root cause of the disturbance in vascular tone is not eliminated, this can lead to a number of pathological changes in the functioning of the nervous system, since nerve cells cannot work normally when there is a deficiency of nutrients and oxygen. In short, there are a lot of reasons for neurovascular disorders. Therefore, in world medicine, a diagnosis is made for the specific disease that caused it, and it is also targeted.

Osteochondrosis: often confused with pain syndrome of other diseases
“There is a very quick and accurate way to confirm or refute suspicions about osteochondrosis - this is an MRI examination of a painful segment of the spine. After all, pain can be a consequence of a disorder that is not related to the spine: pathology or disease of the lungs, heart, kidneys, liver, stomach, intestines," says neurologist Vitalina Radetskaya. “Here is just one case out of many that are erroneous: the patient was treated for osteochondrosis of the thoracic region. When, at my insistence, he went for an MRI, he was diagnosed with tumors in the lungs with metastases to the spine!”

VACCINE: ONE OF THE TYPES OF CANCER HAS ALMOST BEEN DEFEATED IN EUROPE

If we talk about the standards in our and European medicine, then we still have many differences. This also applies to vaccination against the papilloma virus, which causes cervical cancer (CC). In Europe, thanks to national screening programs (sometimes including free vaccination against the virus), morbidity and mortality due to CC have decreased by 80%, says Lina Giragosova, oncogynecologist at the Spizhenko Cyber ​​Clinic. “In Ukraine, you can also get vaccinated (there are two vaccines - 520 and 1650 UAH each), but few people do it, because it’s expensive and people know little about it.”

WRONG DIAGNOSIS: HOW TO SUE DOCTORS
What to do if the doctor makes the wrong diagnosis? Is it possible to go to court? “It’s possible,” says obstetrician-gynecologist and medical lawyer Sergei Baksheev. “The patient must have the original report with the diagnosis, date and two seals - the doctor and the medical institution. As well as a check for payment for medical services or a charitable contribution. It would also be good to have the original referral for examination at the laboratory “N” or a prescription for the purchase of the drug at the pharmacy “X”. In case the doctor finds himself in a commercial relationship with these organizations.”

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Medical errors kill more people in America than AIDS or drug overdoses. That's why.

The Washington Profile portal reports that up to 98 thousand Americans die every year due to pharmaceutical medical errors. Just because of drug intoxication and allergies, about seven thousand people a year are sent to another world in American hospitals. In Great Britain, Canada, Germany, Australia and New Zealand, doctors are more attentive, but even here there are fatal mistakes. A study by the Commonwealth Fund says that 30% of patients in Canada, 27% in Australia, 25% in New Zealand, 23% in Germany, and 22% in the UK face inappropriate treatment, unnecessary medications and late tests.

Doctors often make mistakes due to their youth and inexperience.

A relatively young patient (about forty-seven to forty-eight years old) was admitted with complaints of bone pain and poor health. The examination revealed a sharp acceleration of the erythrocyte sedimentation reaction and a small amount of protein in the urine. Images of the pelvic bones and hips showed only slight diffuse changes (osteoporosis). The diagnosis remained unclear for a long time, but the condition continued to worsen. One day, upon arriving at work, the assistant doctor heard noise in the ward and went in. Several students stood near the patient. He was excited and, seeing the doctor, shouted:
- These bastards broke my arm!

It turned out that the students examining the patient somewhat roughly pulled his arm, trying to lift him to listen, and at that time there was a cracking sound and severe pain appeared in his right shoulder. The examination confirmed a fracture of the humerus. The bone in this place turned out to be eaten by a tumor - myeloma. Subsequent analysis showed that the diagnosis could have been made before the fracture if the doctor had more experience, if he remembered that a sharply increased erythrocyte sedimentation rate, osteoporosis, weakness and protein in the urine are important signs of myeloma. But the assistant doctor just started working after graduate school, and such patients are quite rare. But this is all in the realm of justifications. An error has occurred.

One day a young assistant approached the professor and asked to see the patient.
- Is the patient seriously ill?
- No, this is the case when the patient needs to be shown to the professor...

When examining the electrocardiogram, the professor drew attention to signs of a possible infarction of the posterior wall of the left ventricle. Moreover, the electrocardiologist wrote that myocardial infarction cannot be ruled out. The attending physician and a young assistant diagnosed “right-sided glenohumeral arthritis.” When the patient was brought in, it turned out that he was experiencing pain not in the heart area, not in the left arm, as is typical for most cases of angina and myocardial infarction, but in the right half of the chest.
“When does it arise?” asked the professor.
- When walking and when I’m nervous. Just now I climbed the stairs, and it hurts like this.” The patient ran his hand along the right side of his chest and at the end wrapped his palm around his neck, demonstrating how the pain was suffocating him.

It was clear that we were talking about angina pectoris with an unusual localization of pain. Changes in the electrocardiogram and acceleration of ESR indicated a possible myocardial infarction, which was later confirmed.

Of course, even the most experienced and highly qualified doctors make mistakes. Although others think that this is not so. Explaining the doctors’ mistakes, one of the therapists said that not every therapist can have the art of Mikhail Petrovich Konchalovsky, and not every surgeon can have the erudition and talent of Sergei Ivanovich Spasokukotsky! Thus, it is argued that if all doctors were so talented, they would not make mistakes. While we bow to the talent of outstanding doctors, we can nevertheless confidently assert that they themselves never considered themselves to be infallible. No amount of outstanding ability can save a person from making mistakes. Moreover, doctors who have reached great heights make mistakes more often. The famous Soviet pathologist Ippolit Vasilievich Davydovsky wrote: “It is interesting to note that the number of errors as one’s qualifications improve... increases rather than decreases.”