The take-home message from the paper, says first author Ashley N.D. Meyer, M.D., is that institutions that notice these diagnostic errors need to have a better way of giving doctors feedback, to notify them their original diagnosis was incorrect.
"I think one of the issues is that doctors don't really get a lot of feedback on how accurate they really are, so they can never align their confidence with that accuracy," Meyer says. "Sometimes patients just go to a different doctor, or somehow, the doctor never hears what eventually happened."
She adds that the doctors who were overly confident were part of the problem, but the issue was compounded when they didn't ask for additional resources "when they should have, because they were wrong in their diagnoses."
Singh, who also is Health Policy, Quality and Informatics Program chief at the Houston Veterans Affairs Medical Center, adds that institutions such as hospitals could provide much of this feedback, especially as bundled or global payment models are increasingly applied, or with accountable care organizations that track patients' cost and quality of care over time.