"Diagnostic errors are the outcasts of the patient safety movement," began a story published earlier this month on FierceHealthcare, which noted the oddity, given that diagnostic errors are frequently the leading or second leading cause of malpractice claims in the United States.
Furthermore, most of the harm to patients results from diagnostic errors made in physician offices or other outpatient settings vs. hospitals, Robert L. Phillips Jr., MD, MSPH, Director of the American Academy of Family Physicians' Robert Graham Center for Policy Studies in Family Medicine and Primary Care, told Medscape Today.
And while it's difficult to determine what causes a diagnostic error--a misplaced lab report or a gap in physician training or something else--the Physician Insurers Association of America (PIAA), a group of doctor-owned or operated liability carriers, has narrowed down the top six conditions connected with malpractice lawsuits over diagnostic errors:
- acute myocardial infarction
- breast cancer
- lung cancer
- colon cancers
- medication problems
Physicians' best tools to prevent lawsuits when treating these or any conditions, according to experts, are improved documentation and better communication with patients and colleagues.
No matter how busy a physician may be, the effort of fully documenting an encounter may be his or her best defense if a patient brings a lawsuit. "You can spend an extra minute or two now versus the chance of facing years of misery and worry defending a malpractice suit a few years down the road," said Paul R. Gabel, Vice President for Claims at NORCAL Mutual Insurance Company, a California-based carrier.
While charting, physicians should pay particular attention to noting when a patient denies having symptoms such as fever and pain, using the patients' exact language, and to document the reasons a test was or was not performed, according to Philadelphia malpractice attorney James Griffith.
When it comes to communication, not only is it essential with patients, but also with providers who may be taking over a patient's care. "The advent of hospitalists provides great advantages to patients," said Gabel. "But it's a double-edge sword. Each doctor must be clear on what is diagnosed, what was done and what's the plan of action for when the patient is discharged. It must be clear who is doing the follow-up."
To learn more:
- read the full article in Medscape Today (registration required)