Perspective: Why do doctors make mistakes? Part II

Charles A. Pilcher MD FACEP
March/April, 2013

A study published in JAMA Internal Medicine reveals that the most common causes of medical error resulting in delayed diagnosis and patient harm are “cognitive errors” completely within the physician’s control.

Problems with doctor-patient encounter cause most primary care diagnosis errors. On retrospective review of patients requiring an unplanned admission or repeat clinic visit, the causes were found to be:
* 57% – Failure to order tests indicated by the history and/or exam
* 56% – Failure to obtain a complete or appropriate history of the presenting problem from patient or family member
* 47% – Failure to do an appropriate physical exam related to the presenting problem

Most errors result from simply failing to gather the appropriate data to reach an informed conclusion, or failure to communicate, and not from “system” or “technology” issues. In general these preventable errors led to significant patient harm.

This article is worth keeping in one’s archive of the “basic science” of medical malpractice. When mistakes appear to have been made, understanding how common they are and why they are made can help attorneys on both sides during litigation.

Click here for the complete study. For more on physician errors, see the earlier Medical Malpractice BulletinPerspective” discussing various “cognitive biases” ¬†and how they can lead physicians to erroneous conclusions.

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