40 percent of malpractice claims are for diagnostic errors

By Terry A. Rondberg, DC

Journal of the AMA - logoA commentary published in the July 28 issue of the Journal of the American Medical Association (JAMA) revealed that diagnostic errors are the single largest contributor to medical malpractice claims, accounting for about about 40% of all claims and costing approximately $300,000 per claim.

The authors — Mark Graber, MD, of Stony Brook University Medical Center; and Hardeep Singh, MD, MPH, of Baylor College of Medicine — pointed their fingers at everything BUT the practitioners themselves.

“The great majority of diagnostic errors have root causes that derive from the properties of the healthcare setting, organization and practice,” Dr. Graber said. “By working together, cognitive scientists, informaticians, clinicians, and human factors engineers have a unique opportunity to decrease the likelihood of diagnostic error to the extent that the five principles we outline in JAMA can be incorporated into every new medical home.”

The authors discussed a new model of primary care, called the patient-centered medical home, developed and endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics, American College of Physicians, and the American Osteopathic Association.

The model facilitates partnerships between individual patients, their personal physician, and, when appropriate, the patient’s family. Care is assisted by physician “extenders,” nurse empowerment, information technology, and other means to assure that patients get care when and where they need and want it in a culturally and linguistically appropriate manner.

The medical home model places emphasis on team-based care, and primary care teams could include not only physicians but also nurses, allied health professionals and personnel, the authors explained.

In this model, the medical doctor would be the gatekeeper and decide what role the “allied” health professions would have. “The physician could take a leadership role, while the entire group collectively takes care of the patient,” explained Dr. Singh.

It’s always heartening to see the medical profession recognize and admit the problems inherent in the current disease-oriented system, such as misdiagnoses, prescription errors, unnecessary surgeries, etc.

Still, I’ll continue to work toward the time when we supplant the old paradigm of labeling and treating conditions and symptoms with the new holistic view of the human body as a complex system of energy patterns that responds to non-invasive care such as chiropractic and other “energy medicine” approaches. And I especially look forward to the time when we don’t label all wellness and healing modalities as “medicine!”

4 thoughts on “40 percent of malpractice claims are for diagnostic errors”

  1. One of these days, all health care providers (including chiropractors et.al.) will stop trying to “name” the conditions that cause symptoms. The other day I heard two people arguing over whether a third persona’s sniffling was caused by a cold or a flu. Who cares? Eat healthy, think positive, exercise, get adjusted, and sleep properly and the sniffles will go away (or they won’t happen in the first place).

  2. As long as there is a model promoting the concept and belief in “cause”, the illusion of disease will continue. It’s a dualistic paradigm that nurtures separation, dysfunction, ego, self . . .

  3. Patients (the customers are the problem). When will they take more initiative and make better shopping decisions? They are more assertive when talking to a car salesman at a dealership.

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