DX error by age groups

Michael Grossman Michael.Grossman at MIHS.ORG
Tue Apr 30 17:52:50 UTC 2013


Of interest Choudhry, et al. published an interesting study : Systematic Review: The relationship Between Clinical Experience and Quality of Health Care. Annals of Internal Medicine 2005;142:260-273
This suggests by the methods utilized that physicians who have been in practice longer may be at risk for providing lower quality care. The results were not conclusive and there were many inconsitencies within the collected data. 
It was concluded though that there MAY be an inverse relationship in the quality of care rendered and increasing age , experience. 
I think Dr. Norman probably hit on the answer: there is not enough clear data to have certainty
mg

_______________________________________
From: robert bell [rmsbell at ESEDONA.NET]
Sent: Tuesday, April 30, 2013 10:39 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: DX error by age groups

Thanks Fletcher,

That is interesting - but will we ever find out the truth if Hospitals are reluctant to keep and publish Safety data?

Another thing that I would like to see correlated is Diagnostic Errors and all the other patient errors. What is that relationship over time?

Incidentally, as a more acceptable surrogate time to diagnosis might be appropriate in parameter that a diagnostic error.

I remember reading many years ago that myasthenia gravis took on average 7 years to diagnose.  Have no idea if that was based on any good study.

Incidentally, I am not sure how I go on this list. I did not sign up as far as I know - but it is interesting. Thanks to who ever!!

Rob Bell



On Apr 30, 2013, at 9:58 AM, Penney, Fletcher T wrote:

> On Apr 30, 2013, at 12:07 PM, Robert Bell <rmsbell at ESEDONA.NET> wrote:
>
>> There is data suggesting Docs crash their private planes mor often, but then there may have been other factors e.g. The beachcraft bonanza which lost it's tail section was bought more frequently by physicians. With private planes there is a very cautious period followed by a confident period and then another cautious period. Crashes are low then higher then low again. So complex.
>
> Reminds me of the joke/aphorism I heard back in med school/residency, "The most dangerous person in the hospital is a second-year resident."  Interns know that they don't know much yet.  Third year residents have seen enough to be reminded that they still have much to learn.  Anecdotally, second years sometimes seem to fall into that middle period where their confidence has increased more than their experience, possibly making them more vulnerable to overconfidence induced mistakes.
>
> Fletcher Penney
>
> --
> Fletcher T. Penney, MD, FHM
> Medical Director, Orthopaedic Comanagement Services
> Hospital Medicine
> Medical University of South Carolina
> penneyft at musc.edu
> (T) 843.792.2900
> (F) 843.792.6355
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