Fwd: Study Links Doctor Errors, Bad Diagnoses

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> From: B354@...

> Date: Wed, 4 Oct 2006 14:01:44 EDT

> Subject: Study Links Doctor Errors, Bad Diagnoses

> To: undisclosed-recipients:;

>

>

> Study Links Doctor Errors, Bad Diagnoses

> October 3, 2006

> PHILADELPHIA (AP) -- Basic errors made by doctors, including tests ordered

> too late or not at all and failure to create follow-up plans, played a role

in

> nearly 60 percent of cases in which patients were allegedly hurt by missed

> or delayed diagnoses, a study found.

> Researchers in the study, published in the ls of Internal Medicine on

> Monday, reviewed 307 closed medical malpractice claims, 181 of which

allegedly

> involved diagnostic errors that ended up harming patients. A large majority

> of those cases involved various types of cancer.

> While researchers acknowledged that most claims involved several factors,

> they said major ones included mistakes by doctors: failure to order

appropriate

> diagnostic tests (100 cases); failure to create a proper follow-up plan

> (81); failure to obtain an adequate history or perform an adequate physical

> examination (76); and incorrect interpretation of tests (67).

> Doctors not involved with the study said the findings highlight the fact

> that physicians -- and patients -- need to err on the side of caution when it

> comes to ordering diagnostic tests, keeping detailed records and doing

> follow-up.

> " It seemed like the bottom line was that the problems were problems that

> would occur less if a person was just very compulsive or very diligent, " said

> Dr. Sorscher, an oncologist at Washington University Medical School in

> St. Louis. " It highlights the fact that the causes of serious errors are

often

> preventable. "

> The study's lead author, Dr. Tejal K. Gandhi, director of patient safety at

> Brigham and Women's Hospital in Boston, said the research shows that doctors

> could use more help in making decisions. Things that could help include more

> use of electronic records, better algorithms for making evaluations and the

> use of nurse practitioners to help ensure that follow-ups actually occur, she

> said.

> " I don't want to say that it's not the physician's responsibility, " Gandhi

> said. " We think there could be tools to help physicians make these decisions

> better. "

> The study looked at random samples of claims from four malpractice insurance

> companies throughout the U.S. The reviewers were instructed to ignore the

> outcomes of the claims, all of which closed between 1984 and 2004; nearly 60

> percent of the cases resulted in serious harm and 30 percent resulted in

death.

> All involved missed or delayed diagnoses in office settings.

> Most of the errors occurred in doctor's offices and primary care physicians

> were those most frequently involved. More than half of the missed diagnoses

> involved cancer, primarily breast and colorectal cancer, and biopsies were

the

> test most frequently at issue.

> The researchers said the leading factors that contributed to errors included

> failures in judgment (79 percent), vigilance or memory (59 percent),

> knowledge (48 percent), patient-related factors (46 percent) and handoffs (20

> percent).

> Dr. Langston, chair-elect of the board of the American Medical

> Association, said doctors have become more aggressive in recent years as far

as

> ordering tests such as biopsies and colonoscopies. They also do more screens

> even when the patient shows no symptoms, he said.

> But the study also showed the importance of patients paying close attention

> to their care, voicing their opinions and bringing loved ones with them to

> appointments to help process information and ask questions, he said.

> " Communication issues are major issues, " said Langston, a primary-care

> doctor in Lafayette, Ind. " The message is we need to take a hard look at

what's

> happening and how can we decrease it. "

> Copyright 2006 The Associated Press. All rights reserved. This material may

> not be published, broadcast, rewritten or redistributed.

>

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> From: B354@...

> Date: Wed, 4 Oct 2006 14:01:44 EDT

> Subject: Study Links Doctor Errors, Bad Diagnoses

> To: undisclosed-recipients:;

>

>

> Study Links Doctor Errors, Bad Diagnoses

> October 3, 2006

> PHILADELPHIA (AP) -- Basic errors made by doctors, including tests ordered

> too late or not at all and failure to create follow-up plans, played a role

in

> nearly 60 percent of cases in which patients were allegedly hurt by missed

> or delayed diagnoses, a study found.

> Researchers in the study, published in the ls of Internal Medicine on

> Monday, reviewed 307 closed medical malpractice claims, 181 of which

allegedly

> involved diagnostic errors that ended up harming patients. A large majority

> of those cases involved various types of cancer.

> While researchers acknowledged that most claims involved several factors,

> they said major ones included mistakes by doctors: failure to order

appropriate

> diagnostic tests (100 cases); failure to create a proper follow-up plan

> (81); failure to obtain an adequate history or perform an adequate physical

> examination (76); and incorrect interpretation of tests (67).

> Doctors not involved with the study said the findings highlight the fact

> that physicians -- and patients -- need to err on the side of caution when it

> comes to ordering diagnostic tests, keeping detailed records and doing

> follow-up.

> " It seemed like the bottom line was that the problems were problems that

> would occur less if a person was just very compulsive or very diligent, " said

> Dr. Sorscher, an oncologist at Washington University Medical School in

> St. Louis. " It highlights the fact that the causes of serious errors are

often

> preventable. "

> The study's lead author, Dr. Tejal K. Gandhi, director of patient safety at

> Brigham and Women's Hospital in Boston, said the research shows that doctors

> could use more help in making decisions. Things that could help include more

> use of electronic records, better algorithms for making evaluations and the

> use of nurse practitioners to help ensure that follow-ups actually occur, she

> said.

> " I don't want to say that it's not the physician's responsibility, " Gandhi

> said. " We think there could be tools to help physicians make these decisions

> better. "

> The study looked at random samples of claims from four malpractice insurance

> companies throughout the U.S. The reviewers were instructed to ignore the

> outcomes of the claims, all of which closed between 1984 and 2004; nearly 60

> percent of the cases resulted in serious harm and 30 percent resulted in

death.

> All involved missed or delayed diagnoses in office settings.

> Most of the errors occurred in doctor's offices and primary care physicians

> were those most frequently involved. More than half of the missed diagnoses

> involved cancer, primarily breast and colorectal cancer, and biopsies were

the

> test most frequently at issue.

> The researchers said the leading factors that contributed to errors included

> failures in judgment (79 percent), vigilance or memory (59 percent),

> knowledge (48 percent), patient-related factors (46 percent) and handoffs (20

> percent).

> Dr. Langston, chair-elect of the board of the American Medical

> Association, said doctors have become more aggressive in recent years as far

as

> ordering tests such as biopsies and colonoscopies. They also do more screens

> even when the patient shows no symptoms, he said.

> But the study also showed the importance of patients paying close attention

> to their care, voicing their opinions and bringing loved ones with them to

> appointments to help process information and ask questions, he said.

> " Communication issues are major issues, " said Langston, a primary-care

> doctor in Lafayette, Ind. " The message is we need to take a hard look at

what's

> happening and how can we decrease it. "

> Copyright 2006 The Associated Press. All rights reserved. This material may

> not be published, broadcast, rewritten or redistributed.

>