Posted by: Salvatore J. Zambri, founding member and partner
A new report by the Institute of Medicine, the health arm of the National Academy of Sciences, reveals a critical health system problem that impacts at least 12 million adults each year. The results from an independent panel of medical experts indicate that most Americans will receive a wrong or late diagnosis at least once in their lives. A wrong or late diagnosis is a critical health-care error that can, and frequently does, lead to serious injury, even death. Surprisingly, the focus historically has been placed on medication errors attributed to treatment on a wrong patient or body part. These errors are much less common than diagnostic errors.
IOM was petitioned by the Society to Improve Diagnosis in Medicine, a nonprofit, physician-led organization patient safety group to conduct the study leading to the new report. According to IOM President during a recent news briefing, “Despite the pervasiveness of diagnostic error and the risk for patient harm, they have been largely unappreciated within the quality safety movement in health care and this cannot and must not continue.”
As the diagnostic process and delivery of health care become more complex, chances for errors in diagnostics increase. The chair of the IOM committee and executive vice president emeritus of the American College of Physicians said, “The data on diagnostic errors are sparse, few reliable measures exist and often the error is identified only in retrospect.” Frequently, a misdiagnosis is only identified during an autopsy or as a result of a medical malpractice law suit.
According to the committee’s authors, diagnostic errors can be addressed only by a fundamental overhaul of the entire diagnostic process. A recent article about the IOM report by the Washington Post summarized the committee findings: “Diagnostic errors happen for many reasons, the committee found. There isn’t enough collaboration among clinicians, patients and their families. Clinicians only get limited feedback about the accuracy of their diagnosis. The health-care culture discourages transparency and disclosure of errors. The report also said that health information technology may be contributing to diagnostic errors. More doctors’ office and health systems now have electronic health records, but clinicians often complain the systems are hard to use. ”
The Institute of Medicine has provided a set of detailed goals and recommendations for reducing diagnostic errors in medicine:
- “Facilitate more effective teamwork in the diagnostic process among health care workers, patients, and families.
- Enhance health care professional education and training in the diagnostic process.
- Ensure that health information technologies support patients and health care professionals in the diagnostic process.
- Develop and deploy approaches to identify, learn from, and reduce diagnostic errors and near misses in clinical practice.
- Establish a work system and culture that supports the diagnostic process and improvements in diagnostic performance.
- Develop a reporting environment and medical liability system than facilitates improved diagnosis by learning from diagnostic errors and near misses.
- Design a payment and care delivery environment that supports the diagnostic process.
- Provide dedicated funding for research on the diagnostic process and diagnostic errors.”
Experts also have recommendations for patients to assist in helping to obtain the right diagnosis.
- “Be clear, complete and accurate when you tell your clinician about your illness. When did symptoms begin? What made them better or worse? Jot down notes and bring them with you.
- Remember what treatments you’ve tried in the past, if they helped, and what, if any side effects you had.
- Keep your own records of test results, referrals and hospital admissions. Keep an accurate list of your medications. Bring the list when you see your clinician or pharmacist.
- Remember to ask your clinician these three questions:
- What could be causing my problem?
- What else could it be?
- When will I get my test results and what should I do to follow up?”
Every day, patients are subjected to an alarming number of missed or wrong medical diagnoses. Following the advice above is a way for patients to better protect themselves from medical wrongdoings.
About the author:
Mr. Zambri is a board-certified civil trial attorney by the National Board of Trial Advocates and a Past-President of the Trial Lawyers Association of Metropolitan Washington, D.C. The association recently named him “Trial Lawyer of the Year”. Super Lawyers recently named him among the “Top Ten” lawyers in the Metro Area (out of more than 80,000 attorneys). He has been rated by Washingtonian magazine as a “Big Gun” and among the “top 100″ lawyers in the entire metropolitan area. The magazine also describes him as “one of Washington’s best–most honest and effective lawyers” who specializes in personal injury matters, including automobile accident claims, premises liability, product liability, medical malpractice, and work-accident claims. He has successfully litigated multiple cases against truck and bus companies, the Washington Metropolitan Area transit Authority, and other automobile owners. His law firm, in fact, has obtained the largest settlement ever in a personal injury case involving WMATA. Mr. Zambri has also been acknowledged as one of “The Best Lawyers in America” by Best Lawyers (2014 edition) and has been repeatedly named a “Super Lawyer” by Super Lawyer magazine (2014) — national publications that honor the top lawyers in America.
If you have any questions about your legal rights, please email Mr. Zambri at firstname.lastname@example.org or call him at 202-822-1899.