Every GP can remember missing a cancer diagnosis. These are the cases that stay with you – I remember my first GP trainer in 1999 telling me about a missed ovarian cancer. My notable one was a rectal cancer at 7cm, and from that day forward, I always recorded “PR normal to 6.5cm”, the length of my forefinger. No GP goes into medicine to make mistakes but inevitably each of us will. Despite our best intentions, we can be plagued by thoughts of having missed something vital.
In hindsight, it is sometimes possible to see where a GP could have done something differently: pushed for a CT chest or abdomen, repeated a blood test earlier, but sometimes it can be just the Swiss Cheese effect: a toxic combination of different factors which resulted in false reassurance for your patient until it was too late, particularly where a patient already has multiple chronic conditions to explain why they feel unwell.
Add into the mix the biggest change to have happened in medicine for many years: remote consulting. Couple that with a global pandemic and you’ve got all the ingredients for delayed and missed diagnoses galore.
