Thoughts on diagnostic errors in 2017

The Society to Improve Diagnosis in Medicine has on its website this quote: Reducing Harm from Diagnostic Error 1 in 10 diagnoses are incorrect. Diagnostic error accounts for 40,000-80,000 US deaths annually—somewhere between breast cancer and diabetes. Chances are, we will all experience diagnostic error in our lifetime. (US Institute of Medicine 2015, BMJ Quality & Safety 25-Year Summary of US Malpractice Claims, 2013.) The current focus on diagnostic error raises an interesting question:  Is this a larger problem in 2017 than in the 1970s and 1980s? In this post, I postulate that the problem has increased.  Several factors likely contribute to the problem.  Of course, I may just be an old guy pining for the “good old days” (that actually were not that great), but I will leave that postulate to your interpretation. The diagnostic process requires that the physician first value diagnosis and respect its complexity.  The best diagnosticians are skeptical questioners.  They never assume a diagnosis, but rather challenge every diagnosis, at least internally and often externally. Unfortunately, our health care payment process has implicitly undervalued the diagnostic process.  The current guideline process often over simplifies diagnosis or assumes the diagnostic process occurs prior to needing the guideline. A few examples might put these thoughts into context.  Sore throat guidelines have oversimplified acute sore throat diagnosis into group A strep ...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs