Diagnostic errors made in hospitals are responsible for up to 80,000 deaths every year. Now a study in JAMA Internal Medicine demonstrates that diagnostic errors are also a serious problem in outpatient settings.
The investigators used medical records to track down 190 cases of diagnostic error made in primary care clinics. The large variety of mistakes in diagnosis had significant potential for harm. Of the 190 patients, 36 experienced lasting serious harm and 27 others died. The kinds of diseases that were not diagnosed correctly included pneumonia, congestive heart failure, kidney failure, cancer and urinary tract infections. The breakdown was largely traced to failures in doctor-patient communication. An accompanying commentary in the journal suggests that at least 150,000 Americans experience severe harm or death from misdiagnosis each year. [JAMA Internal Medicine, online, Feb. 25, 2013]
We have discussed the difficulties of diagnosis several times with prominent physicians on our radio show. You may be interested in Diagnostic Errors, Diagnostic Puzzles, The Underbelly of Health Care, or The Art of Diagnosis.