Diagnostic Errors Common, Costly, and Harmful
Wrong site surgeries and medication mishaps get all the gory malpractice headlines, but diagnostic errors are a larger, deadlier, and costlier problem, according to a study released Monday by Johns Hopkins researchers.
"We have said repeatedly that the fundamental premise is if you don't have the diagnosis right you can't possibly get the treatment right unless occasionally you get lucky," says David E. Newman-Toker, MD, an associate professor of neurology at the Johns Hopkins University School of Medicine and leader of the study being published online in BMJ Quality and Safety.
"The correct premise is that correct therapy begins with correct diagnosis. Unfortunately the entire medical profession operates under the collective delusion that diagnoses are almost always right," Newman-Tucker says. "There are all kinds of things we track in the hospitals; quality measures of one kind or another. But nobody is tracking whether or not their diagnoses are right. It's either ironic or scary but it's not good."
The Johns Hopkins researchers reviewed 350,706 malpractice claim payouts between 1986 and 2010 and found that diagnostic errors accounted for 28.6% of the claims, the most severe patient harm, and punitive payouts that amounted to $38.8 billion.
The study examined only a subset of claims that prompted a malpractice payout, but the researchers estimated that between 80,000 to 160,000 patients suffer misdiagnoses-related, potentially preventable, significant permanent injury or death annually across the nation.