#23 How many Health Care Dollars are Wasted on the Misdiagnosis of TMD?
The answer to that question is unknown and very hard to calculate. It is unknown for several reasons. First, we do not know how many times health care providers misdiagnose TMD as something else. But we do know it is very common. Second, we cannot calculate the cost of a misdiagnosis accurately because once the patient is sent on a wild goose chase with a misdiagnosis the diagnostic and treatment procedures and drugs can vary widely. And third, once a misdiagnosis is made the patient may carry that misdiagnosis for many years, sometimes decades, visiting many different doctors and clinics.
Having done over 4000 consultations for patients who did have TMD/TMJ, I can make estimates however based on what patients have shared with me about their experiences, number of doctors and clinics visited, and the number of dollars spent out of pocket and by insurance carriers for diagnostic studies and treatments based on misdiagnosis.
It is very easy to make a misdiagnosis regarding TMD/TMJ because the symptoms are so disparate and confusing and most often mimic common diagnoses.
The three most common problems misdiagnosed are headache, neck pain, and earache.
When a PCP is confronted with a patient with recurrent, frequent, and unresolved headaches, the first thing is an MRI in ordered to rule out brain tumors. Cost of an MRI, $2,000. How do I know this is fact? I recently lectured to a room fully of board-certified family practice physicians. I asked, “what is the first thing you do when faced with a patient with unresolved and frequent severe headaches” They all responded: “MRI”. Many patients with severe, long-standing headaches have undergone multiple MRI’s. Half of our patients have 15 to 20 years of symptoms before an accurate diagnosis of TMD is made. One patient claimed that over a period of 30 years of symptoms she had 5 MRI’s. Another patient claimed she had 150 consultations from different providers over a period of 35 years regarding her headaches. She swore she was not exaggerating. How many health care dollars were wasted in each of these cases is impossible to determine except to say it was all wasted until an accurate diagnosis of TMD was made and appropriate treatment started. What percentage of migraine headaches are actually TMD headaches. We don’t know. We do know we have treated at least 2000 patients that have been diagnosed with migraine headaches which turned out to be TMD headaches. That is a lot of MRIs, and inappropriate migraine headache medication.
Neck pain is also frequently misdiagnosed. I have seen several patients who had spinal surgery for chronic neck pain which persisted after surgery and responded completely to non-surgical TMD splint therapy. It is common to see patients with months to years of physical therapy or chiropractic care which gives only temporary relief and responded to unloading the TMJ’s with the Urbanek Device and Protocol with permanent symptom resolution. How many health care dollars were wasted. That is impossible to calculate except to say, “quite a lot”.
Ear infection is the catch all diagnosis for a patient who presents to a convenient care clinic with an earache. Each patient will walk away with a prescription for antibiotic. Many patients will see two or three convenient care clinics before they are referred to an ENT doctor who takes one look at the ear and states, “There is no infection in the ear”, presses on the TMJ with his finger which elicits some pain and sends the patient in for TMD/TMJ treatment. How many health care dollars were wasted? Take a guess. Your guess is as good as mine.
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