Another argument for patient's access to their test results

David Gordon, M.D. davidc.gordon at DUKE.EDU
Mon Apr 21 14:19:57 UTC 2014

Hi Mark,

I don't have more to offer about the details of the case, but this type of activity is similar in my mind to the many examples of individuals (successfully) pretending to be doctors. This is another example of "impersonation" - in this case the technician is impersonating the role of the radiologist. Or you might make the distinction between someone with no medical background impersonating a health care professional versus a health care professional overstepping their professional role and performing activities outside of what they are licensed/credentialed to do - like Michael Jackson's cardiologist administering propofol. You might call this inappropriate  - or illegal - role expansion. 

For classification and accounting purposes, it is an interesting question of whether your really count these as diagnostic/medical errors? I guess you could call it a system error - "Bad Apple."  But personally,  I think these types of activities - in which people are doing things they have no business doing -  are different from what is intended by the term diagnostic error and would treat them separately as diagnostic or medical misconduct. 


David Gordon, MD
Associate Professor
Undergraduate Education Director
Division of Emergency Medicine
Duke University

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From: Graber, Mark [Mark.Graber at VA.GOV]
Sent: Sunday, April 20, 2014 11:02 PM
Subject: [IMPROVEDX] Another argument for patient's access to their test results

In a very disturbing story this week, a radiology tech was accused of notifying 1000+ women that their mammagrams were normal, although she didn't know this to be true, and some in fact were not.

Its my understanding that all women are supposed to receive a copy of their test result, and its not exactly clear from this report if the tech just gave women a verbal 'ok', or if she actually altered the radiologist's report.  This is a class of diagnostic error I've never encountered before, but I'm hoping that the directly-mailed results mitigated the tech's false assurances.  If anyone has access to more facts on this case, I'd be interested to hear them.

Mark L Graber, MD FACP
Senior Fellow, RTI International
Professor Emeritus, SUNY Stony Brook School of Medicine
Founder and President, Society to Improve Diagnosis in Medicine

Moderator: Lorri Zipperer Lorri at, Communication co-chair, Society for Improving Diagnosis in Medicine

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