• Question: what would you do in a situation where you know you’re right when it comes to a diagnosis, but your colleagues don’t agree?

    Asked by anon-357473 on 20 Mar 2023.
    • Photo: Angela Short

      Angela Short answered on 20 Mar 2023:

      Really interesting question. In a laboratory we have Standard Operating Procedures (SOPs) which tell us exactly what steps we have to do to in a test. This way, every person does the test the exact same way each time and we set criteria as to what is a positive result and what is negative result is. We also use controls to limit any factors that may vary between tests.
      However, diagnostics can be complicated so we don’t focus on who is ‘right’ and who is ‘wrong’ but rather on what evidence we have and what that might mean. If the evidence we have doesn’t strongly suggest an answer one way or another, we might need to gather more evidence to help support one idea over another.

    • Photo: Edward Guy

      Edward Guy answered on 20 Mar 2023: last edited 20 Mar 2023 1:38 pm

      The quick answer is that where there is a disagreement, we review all the evidence together so everyone understands how each of us got to our own conclusion, and we may decide on further tests just to check which diagnosis is the most accurate before proceeding. Once all the evidence is reviewed and discussed, there is rarely any big disagreements over diagnosis.

      The longer version 🙂
      A diagnosis can be quite complex to arrive at, and may be the result of a number of different disease processes all working together (maybe one or more infections at the same time as cancer, for example). So, sometimes the discussion is around which of these is driving the disease and which are simply happening as a consequence (we call these latter ones ‘opportunistic’). Therefore, there can be debate (and clinicians might have different views) on what the best initial treatment might be. What we tend to do in these cases is agree a ‘Plan A’, Plan B’, etc. around what treatment to give, but we also agree how long to use that Plan before we might need to change it. We will also agree what measurements or other tests we can carry out to see if that Plan is working.

    • Photo: Nazakat Merchant

      Nazakat Merchant answered on 24 Mar 2023:

      You discuss together why you think that is the diagnosis and give your reasons as evidence based. If you still dont agree with your colleague go to a third person- a senior etc. We often use risk versus benefits which helps us to come to a consensus. Remember the goal of all of us is the same i.e. to save the patient.

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