There's no question that some diagnoses are difficult to make. When doctors attended school, most were given the same advice: Don't look to rare possibilities first. Start with the basics, since those are the most likely causes of injuries or illnesses.
The problem for some is that their patients will end up with rare diseases or illnesses. While most of these cases won't cause a malpractice lawsuit if the patient takes longer to be diagnosed, it's a possibility to face a lawsuit if you diagnose the patient with the wrong condition.
How can you avoid a medical malpractice lawsuit?
Look to the basics first, much like you learned in school. If someone has a fever and cough, the normal and most likely cause is a common cold. If he or she doesn't respond appropriately to medications, move on to another possibility. It's necessary for medical providers to keep an eye on patients who have unusual symptoms, so they can adjust their treatment plans as diseases or illnesses are ruled out.
Many medical providers attempt to avoid malpractice lawsuits by running every test they can think of. That may not be necessary, but it's still a good idea to refer to the patient's preference. State that you have the options, so the patients have the chance to deny or accept your preferred diagnostic tools.
If a patient is continually not responding to treatments, there's likely something that's been missed. At this point, consider bringing a specialist or colleague in on the case. Patients will feel much better about two doctors working to solve a difficult case than they would in a situation where they believe their medical provider is too assured of him or herself.
At the end of the day, there are some diagnoses that are extremely difficult to make. Some illnesses only occur in 1 out of 200,000 patients. Whatever happens, do your best for the patient, and it will protect you.
Source: Medscape, "When Missing a 'Zebra' Can Land You in Court," Mark Crane, Feb. 20, 2018