Diagnostic Errors in Primary Care Settings

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A recent study of the types and origins of diagnostic errors in primary care settings was recently published in the Journal of the American Medical Association. The authors found that medical errors such as pneumonia, decompensated congestive heart failure, acute renal failure, cancer, and urinary tract infection or pyelonephritis were most common in primary care settings. The researchers found that such errors were most typically caused by process breakdowns which most frequently involved the patient-practitioner clinical encounter but were also related to referrals, patient-related factors, follow-up and tracking of diagnostic information, and performance and interpretation of diagnostic tests. A total of 43.7% of cases involved more than one of these processes. Patient-practitioner encounter breakdowns were primarily related to problems with history-taking, examination, and/or ordering diagnostic tests for further workup.
These errors and their root causes are preventable and may cause great harm to the patient. Yet these diagnostic errors continue to occur in primary care setttings.

Mark Abramson
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