robert bell rmsbell200 at YAHOO.COM
Tue Feb 24 03:15:48 UTC 2015

It seems that getting to understand all the nuances associated diagnostic errors in medicine is a Herculean task at this time and that we probably need a completely new approach to diagnosis supported by computer programs far in excess of anything that we have now.

If that is the case, and we have to wait for years and years to get close to “singularity” to start to do anything really meaningful, why do we not focus on more simple things with simple guideline recommendations.

These could be the use of simple lists.
Perhaps standards on ways to organize thoughts.
Reviewing and supporting some of the current diagnostic programs that are marketed to physicians.
Providing lists of commonly made errors in different sub-specialties.
Diagnostic pearls, and recommendations to help better distinguish serious conditions.
Improving accuracy in, and reducing errors in Doctor’s offices (that often become transferred to the hospital environment).
Etc., Etc

Here is one example - nearly every time I have contact with a Physicians office they make a mistake. Most mistakes are innocuous but with the swiss cheese phenomenon coordinating them, it can/could be fatal.  

Just today I made an appointment to see a physician and without apparent difficulty the appointment was made. The office person obtained three identifications including my address which I admired. However, before hanging up, I said "is the appointment for the ABC office where I live (which is about 15 miles from the main XYZ office). "Oh no, it was for the XYZ office.” "Let me have another look - I can now get you in a week earlier at the ABC office."
So why not recommend that every Doctor’s Office in the nation has the equivalent of a Safety Officer, who collects error incidents and brings them to the physician and other office staff on a periodic basis for solving/correcting?

This is not to forget the hard tough diagnostic challenges and the computer technology that will go with that progress and development as we march towards singularity. that obviously needs important work. 

But it seems to me that we could nationwide reduce right now diagnostic errors in medicine by focussing on the simple things.

I would think that we could readily reduce errors in diagnosis by 1 - 5% by having simple recommendations and support aids. That alone would be amazing.

What about a dedicated conference, with a defined purpose and goals to take this forward?

I do believe we could make significant progress NOW.


Rob Bell, M.D.

Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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