"The whole medical enterprise is based on the fact that one goes to a doctor in the belief that doctors usually know what they're doing, otherwise you won't go. If a doctor said, 'you know, I'm kind of wrong half the time,' no one is going to come to them."
Singh's area of research focuses on diagnostic accuracy, an issue that's increasingly important for measuring quality of care, and which some say should be among the measures used to determine physician performance and payment. In a February report, he quantified common errors in physician practice resulting in diagnostic error, for example, a failure to take an adequate medical history or deficiencies in the physician's performance of the physical exam.
In this study, 118 physicians from around the country agreed to participate, and were asked to correctly diagnose four case "vignettes," based on real cases. They were recruited through QuantiaMD.com, an online community of physicians who review clinical evidence from experts and exchange knowledge.
Two of the cases were easy and the other two more difficult. There were four phases of opportunity to gather information about the case, as close to possible as an actual physician-patient encounter: the chief complaint and medical history, physical exam, laboratory and imaging studies, followed up with definitive or specialized lab and imaging tests.