Diagnostic Errors

The type of medical error that accounts for the most severe patient harm and the highest malpractice payouts is a diagnostic error. Between 1986 and 2010, >$38 billion was paid out in malpractice claims due to diagnostic errors. As reported in the BMJ of Quality and Safety, out of the total 350,706 paid claims, diagnostic errors were the leading type (28%) and accounted for the highest proportion of total payments (35%). Unlike other patient safety issues where a relatively straightforward "fix" can be utilized, such as barcode scanning for medications, diagnostic error prevention is more complex. Even determining the extent of the problem may be difficult as this study only examined errors that generated malpractice claims. Some solutions that individual practitioners can apply include a "diagnostic time out", performing a complete history and physical exam on every patient, and always generating a comprehensive differential diagnosis, including asking the question "what is the worst thing this could be?"