Diagnostic Errors are Serious Threats to Patient Safety Says Doc
One of the most popular prime-time television shows in the US is House MD, a show about a diagnostician who tackles complicated cases at the fictitious Princeton-Plainsboro Hospital. The doctors on the team often go through several “working diagnoses” before ultimately reaching one that saves the patient’s life. But real life isn’t like a TV show, and diagnostic errors are the most important causes of avoidable harm to hospitalized patients, according to a senior doctor in the UK.
Doctors Need More Resources for Correct Diagnosis and Treatments
Dr. Gordon Caldwell, a consultant physician at Worthing Hospital in Western Sussex, believes that doctors need better facilities and sufficient time to make a correct diagnosis. He warns that “the time taken to reach the correct diagnosis may critically impact on the patient’s chances of survival” but little consideration is given to the time it takes to reach the appropriate conclusion for optimal patient care.
Writing an editorial for the British Medical Journal (BMJ), he writes “We must design our working spaces and information spaces to maximize doctors’ ability to see, understand, and deliberate on the information needed for more precise diagnosis. We must allow clinicians enough time to be careful in diagnosis, treatment planning, and treatment review. ”
Errors in diagnosis place a heavy financial burden on the health care system, according to a recent study from the Baylor College of Medicine. According to Dr. Hardeep Singh, “Diagnostic errors are the single largest contributor to malpractice claims (about 40 percent) and cost approximately $300,000 per claim.”
He agrees that coordination, communication and continuity of care deficits are associated with errors in medical diagnosis and that a comprehensive model of primary care, called a patient-centered medical home, could potentially address this safety concern.
A patient-centered medical home, a model endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Osteopathic Association, places emphasis on team-based care to include not only physicians, but also nurses, allied health professionals and administrative personnel.
The medical home model also emphasizes proper information management, measurement and monitoring, a culture of safety, and patient empowerment.
1. Caldwell, Gordon. What is the main cause of avoidable harm to patients? BMJ 2010; 341:c4593 doi: 10.1136/bmj.c4593 (Published 9 September 2010)
2. Hardeep Singh; Mark Graber. Reducing Diagnostic Error Through Medical Home-Based Primary Care Reform.JAMA, 2010; 304 (4): 463-464 [link]