Tejal K. Gandhi, MD, MPH; Allen Kachalia, MD, JD; David M. Studdert, LLB, ScD
Potential Financial Conflicts of Interest: None disclosed.
Gandhi TK, Kachalia A, Studdert DM. Missed and Delayed Diagnoses in the Ambulatory Setting. Ann Intern Med. 2007;146:470-471. doi: 10.7326/0003-4819-146-6-200703200-00023
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Published: Ann Intern Med. 2007;146(6):470-471.
We agree with Dr. Clairmont's suggestion that greater transparency of errors in malpractice claims would advance patient safety. If appropriately identified, such information could help pull the liability system toward a broader culture of openness in which mistakes are seen as valuable opportunities to improve care, not as problems to be hidden. All errors, regardless of whether they prompted malpractice claims, should be construed and discussed in this light.
We are disappointed by Dr. Clairmont's view that our findings will not help primary care physicians. By highlighting several points in the diagnostic processes in which breakdowns frequently occur and proposing several relatively “low-tech” prevention strategies, we believe the research provides some practical guidance for clinicians.
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