This month, an excellent paper came out on the subject of diagnostic errors.
Volume 121, Issue 5, Supplement, Pages S2-S23 (May 2008)
Overconfidence as a Cause of Diagnostic Error in Medicine
Eta S. Berner, Mark L. Graber
The authors concentrate on doctor overconfidence. The paper indicates that doctors seldom follow published medical guidelines, seldom refer to books, seldom refer to general omputer-based diagnostic aids, and have a more-or-less reflexive approach to diagnosis. Not surprisingly, the authors' review of the literature also indicates that diagnostic accuracy has not improved much over the decades.
None of this is surprising. A prior publication indicates that many doctors and nurses (less so nurses than doctors) do not wash their hands when they should (See: Lipsett PA, Swoboda SM. Handwashing compliance depends on professional status. Surg Infect (Larchmt). 2(3):241-245, 2001). Some of the most vicious hospital outbreaks of antibiotic-resistant organisms are exacerbated by inadequate handwashing among hospital staff. If doctors can't be bothered to wash their hands, how can you expect them to be responsible in the more demanding areas of patient care?
I encourage physicians and other patient-care professionals to read these articles. Understanding the source of medical errors is a good start towards improving care.
In June, 2014, my book, entitled Rare Diseases and Orphan Drugs: Keys to Understanding and Treating the Common Diseases was published by Elsevier. The book builds the argument that our best chance of curing the common diseases will come from studying and curing the rare diseases.
I urge you to read more about my book. There's a generous preview of the book at the Google Books site. If you like the book, please request your librarian to purchase a copy of this book for your library or reading room.
- Jules J. Berman, Ph.D., M.D. tags: common disease, orphan disease, orphan drugs, rare disease, subsets of disease, disease genetics, errors, handwashing, physicians, standard of care, cad, hand-washing