One of the reasons that Nigerians fail to trust doctors is in the area of misdiagnosis and the reasons are legion. Diagnosing pneumonia for cancer calling cancer, tuberculosis, is all too common. Stroke is often misdiagnosed. One of my recent patients with arthritis was misdiagnosed as stroke and so prevented from effective therapy for months. Typhoid is also a very common diagnosis in Nigeria, by doctors who do not know better. Malaria has been blamed in error, so much that if I was malaria, I would have left town long ago.
Poor laboratory services
Why is malaria and typhoid diagnosed all the time? This is often because the commonest tests performed by our ubiquitous laboratories are malaria and typhoid. After all, they must eat and no one is supervising the training or regulating their activities. We are not even trusted by many international AIDS organisations to diagnose HIV properly because, at times, they get it spectacularly wrong and you know how devastating that could be.
Poor radiological services
The other source of poor acumen is the radiological services. Many doctors are truly untrained in radio-diagnosis and I trust very few reports from our radiologists. Many just gamble and are so bad it hurts to read what they write as reports. In many situations, they actually mean well but are limited by poor exposure to common sense. Many radiologists fail to go the extra mile and confirm the diagnosis. At the end of the day, the patient becomes confused with multiple diagnoses. I blame the radiologists! They blame the referring doctor! The patient blames all the doctors! We all blame one another till the pathologists arrive.
Poor clinical services
About a year ago, I attended a conference of the Ophthalmological Society of Nigeria to talk about patients with visual loss due to brain tumours that have been misdiagnosed. Many of the patients had been seen by several optometrists and ophthalmologists before the penny dropped. They had been offered several prescriptions for glasses and treatments for glaucoma in error. The optometrists and ophthalmologists were only interested in selling eyeglasses to these patients and then sat back watching them go blind. The real diagnosis was huge brain tumours causing blindness. This could have been easily diagnosed through a careful history and examination.
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