NAM report on health inequity

Mark Graber mark.graber at IMPROVEDIAGNOSIS.ORG
Mon Jan 16 03:30:27 UTC 2017


Paul, thanks for posting both of your comments.  I visited Susquehanna as well this year, and for sure they deserve recognition for being out in front on this.  Maine Medical Center is another locale that is taking diagnostic error seriously.  I hesitate to start making a list for fear of leaving anyone off, but there is also notable progress at Penn, Pittsburgh, Partners, Hopkins, at KP Southern California, UCSF, within the VA system, and at many other places. I would love to hear from other organizations that would like to be included on this list.

That's the good news.  The bad news is that there are 5000+ hospitals in the US, and I'm guessing that diagnostic performance is NOT on the front burner at 99%

As an internist, I'd also like to see the ACP leading the charge.  Its nice that there was 1 program session on cognitive bias, but there should be a LOT more.

Mark

Mark L Graber, MD FACP
President, SIDM



On Jan 15, 2017, at 5:48 PM, Paul Foster, MD <PFoster at GBMC.ORG> wrote:

For the fun of it, I searched for “error” in the 2017 ACP meeting program. I got 7 hits, of which only 2 directly addressed diagnostic error – one on combatting cognitive biases, and another on case based clinical reasoning in the hospital. As the leading meeting of the specialty which should be leading the charge, the ACP has not apparently gotten their head around the size and urgency of the problem.  Maybe just not enough consensus yet on the practical steps we should be taking.
 
In contrast, in December, I gave a talk at UPMC Susquehanna. There Don Hess has invested 25% of his grand rounds in the last year to exploring diagnostic error. For a small place, they may be farther along on this agenda than many much larger centers. It led me to wonder whether there are other hospitals that are successfully changing the culture of their rank and file, and how they are doing it.
 
From: Mark Graber [mailto:graber.mark at GMAIL.COM <mailto:graber.mark at GMAIL.COM>] 
Sent: Saturday, January 14, 2017 2:17 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] NAM report on health inequity
 
The National Academy just released a major (530 pages !) report on health inequity.  Diagnosis was mentioned just twice in passing, reflecting on diagnostic delays in the homeless and native Americans.  This is an area with LARGE research gaps - it is very likely that diagnostic error is substantially more likely in AHRQ's special populations.
 
 
http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/62502?xid=nl_mpt_DDendo_2017-01-14&eun=g8116817d28r&pos=111111111 <http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/62502?xid=nl_mpt_DDendo_2017-01-14&eun=g8116817d28r&pos=111111111>
 
Mark L Graber MD FACP
President Society to Improve Diagnosis in Medicine (SIDM)
Senior Fellow, RTI International
Professor Emeritus, Stony Brook University

 
 
 
 

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


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