Diagnostic Errors Common, Costly, and Harmful
Newman-Toker spoke with HealthLeaders Media about his findings. The following is an edited transcript of the interview.
HLM: Were the results you got the results you expected?
N-T: We were anticipating most of the results. There were certain aspects of this that we expected, but there wasn't prior literature. For instance: The high frequency with which claims were associated with disability and not just death. That has not been previously looked at and that is one of the most important findings from the data we analyzed.
It really indicates that the magnitude of the problem as has been previously assessed through autopsy studies is a significant underestimate of the serious negative impact and harm associated with diagnostic error.
HLM: What seems to be the pitfall here?
N-T: There are no quality measures that systematically ask the question 'What is our accuracy of diagnoses?' 'How often do we make diagnostic errors?' 'What is the impact of those diagnostic errors?' The call to action message from this paper and many others that we have tried to publish over the last five to 10 years to shed light on this problem is that we must systematically measure diagnostic errors. It must be a requirement and it must be part of the quality reporting guidelines in order for us to start tackling this problem."
HLM: What is the source of this diagnostic disconnect?
N-T: I don't think it is arrogance, although some of it is overconfidence in the sense that we have a system that does not give us a great deal of feedback on the accuracy of our diagnosis. Not every patient gets the same follow-up. The patients who come back to see us come back because they are satisfied and they like us and they send us Christmas cards and knit us shawls and we think of ourselves as good diagnosticians as a result.
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