Is Misdiagnosis Common? More Than You Think

We’ve all heard a horror story or two of someone who was medically misdiagnosed. Someone was told it was cramps when it was really an ectopic pregnancy. Someone was told they had migraines when it was actually a brain tumor. While these instances are not specific to any one person, it has probably happened. However, this problem is incredibly more rampant in minority communities. Why is that?

The Issue of Bias

The world knows that humans grow up with inherent biases, whether implicit or explicit. Unfortunately, this trend impacts communities of color more than their white counterparts. The Society to Improve Diagnoses in Medicine states that “If you are a patient of color, especially if you’re of African ancestry, your chances of misdiagnosis are greater than white patients’, and you have higher odds of suffering greater harm from diagnostic errors than they do.”

This holds true – a report from the Pew Research Center in 2019 found that “about 76% of Black and Asian people and 58% of Hispanics” have said that they have faced discrimination or bias based on their race. This discrimination was highlighted in their updated 2020 report, where around two thirds of the Black people polled said that they are treated less fairly than white people when it comes to medical issues (76%).

Where Do People See This Happening?

It’s not like this is a problem that is just emerging or that the government doesn’t know about this disparity. The University of Virginia’s Batten School of Leadership and Public Policy stated that the US Department of Health and Human services found that “Black and Hispanic people receive worse care on 40% of the department’s care quality measures.” 40%. That’s 2/5 of their quality measures failed.

Sophie Trawalter, a Batten professor and social psychologist, said in a talk that white people believe that Black patients experience less pain and are statistically more likely to receive little to no pain management treatment. This is not just true of Black men, but of Black women and children as well.

It is a notorious fact that Black women have a high mortality rate during childbirth. KFF published a study that directly states that “Black and American Indian and Alaska Native women have higher rates of pregnancy-related death than white women,” with mortality rates being two and three times higher (respectively) than white women. This affects all women – many know the story of Serena Williams having to repeatedly advocate for herself after birth for a doctor to check her blood clots.

Is It Just Medical?

One of the most common misdiagnoses people of color face is mental disorders. On average, the most commonly misdiagnosed disorders for people of color are major depressive disorder, bipolar disorder, and schizophrenia, to name a few. This is extremely dangerous – untreated and unchecked disorders can lead to serious ramifications for patients who may need help.

Many studies show that the implicit bias for patients of color exist in the mental health community as well. One reported that Black and Hispanic people are more likely to be diagnosed with schizophrenia if they exhibit erratic behaviors, while white people may receive more specified diagnoses for the same behaviors. Others show that people of color are disproportionally diagnosed to multiple factors, such as lack of access and mental health stigma, to name a few.

I’d like to tell you a personal story. When I was in high school, I went through radical changes. I was all over the place. My mom attributed it to hormones, but she took me to a therapist who said I suffered from major depression. I stayed with that diagnosis throughout college, even though my behavior became more and more erratic. While attending therapy in college, I was given an antidepressant – Celexa, or citalopram. It worked like a charm – I felt so much better and happier, even though I still had moments.

All of that changed when I turned 23. My psychiatrist found that I was doing so well, she weaned me off the Celexa. From there, it went downhill. I went on a 6-month bender, doing drugs, drinking, turning anorexic, and contemplating leaving it all. I went to a free clinic after many family members expressed concern for me, and I was mind blown. It turns out I didn’t have depression, I had bipolar II disorder. It was like a rainbow came out. We finally knew what it was (to this day, I remember my dad saying, “Oh my God, it all makes sense now).

You would think after years, things would have gotten better, and they are for the most part. I apparently also have anxiety and ADHD. It shouldn’t take 16 years for someone to be properly diagnosed.

Who Does This Fall On?

Honestly? The case of misdiagnosis falls on everyone. Doctors must do more to combat their inherent biases. Patients of color must not only insist on advocating for themselves but combat their feelings of mistrust to present all of their issues and symptoms with doctors. Communities of color also must acknowledge that these issues are real and not something to be written off. If we can all educate and help each other, medical care can finally improve for us all.