According to the American Medical Association (AMA), diagnostic error such as missed, delayed, or incorrect diagnosis is an underemphasized but extremely relevant safety concern in primary care medicine. Possibly the leading type of error in primary care, the AMA reports that diagnostic errors may be the largest contributor to ambulatory malpractice claims that cost an average of $300,000 per claim.
The AMA believes that, if implemented correctly, patient-centered medical homes like long-term care facilities and nursing homes can address many pressing safety issues, especially errors in diagnosis. The principles of the patient-centered medical home were developed jointly and endorsed by the American Academy of Pediatrics, the American Academy of Family Physicians, American College of Physicians and the American Osteopathic Association.
The patient-centered medical home model facilitates partnerships between patients and their physicians. Under the model, medical care is assisted by physician “extenders,” nurse empowerment, information technology and other means that help patients get the right care at the right time. The AMA envisions changes under the model that improve coordination, communication and continuity of care, deficits of which are associated with diagnostic errors.
According to 2009 statistics provided by the AMA, an estimated 40,000 to 80,000 U.S. hospital deaths result from diagnostic error annually. Roughly five percent of autopsies reveal lethal diagnostic errors for which a correct diagnosis followed by treatment could have averted death. In a Harvard Medical Practice Study, physician errors resulting in adverse medical events were more likely to be diagnostic than drug-related. Additionally, the American Journal of Medicine has reported a diagnostic-error rate of less than five percent up to fifteen percent in certain medical fields.
Statistics like these show that there is room for improvement in making accurate and timely diagnoses. Hopefully more medical care providers will follow the AMA’s lead and strive for fewer errors in a patient-centered model of care.
