Diagnostic Error Detection Comes Into Focus
High Rates of Misdiagnoses
However it's defined, some studies put the number of missed or incorrect diagnoses at between 10% and 15%, depending on the specialty, he says. Autopsies see diagnostic discrepancies between 10% and 20% of the time, and half of the pediatricians answering a large survey said that they misdiagnose between once and twice each month. Radiologists get it wrong 2% of the time, he says.
But those are all guesses. Primary care settings, clinics, and emergency departments represent the lion's share of misdiagnoses, often because of system miscommunication, Singh says.
"You're getting lots of tests done at the same time, blood, X-rays and CT, and they're delivered across multiple systems and settings that aren't always communicating with other. It's fragmented, and the diagnostic process becomes much more vulnerable in that setting."
But Singh, who is also an associate professor at Baylor College of Medicine, is extremely optimistic that providers are ready to acknowledge all this and take this problem head on. They need to define what exactly they mean by a misdiagnosis or "missed opportunity," and zero in on the most likely causes.
7 Reasons Diagnostic Errors are Gaining Attention
Singh gave me a quick rundown of why diagnostic error detection and prevention might finally be getting more respect:
1. Incentives. The creation of ACOs and other forms of shared savings programs will reward clinicians who achieve correct diagnoses with minimal use of expensive testing and specialty referrals. Primary providers may order tests for the most likely or potentially the most serious medical problems first.
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