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Medical Errors Often Stem from Primary Care Physicians

Update Date: Feb 26, 2013 11:53 AM EST
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Investigators found that a huge number of medical errors are linked to diagnostic errors that stem from primary care physicians. The study, which was published in the Journal of American Medical Association Internal Medicines, found roughly 200 errors made by primary care physicians due to miscommunication between the physician and the patient resulting in wrong diagnoses and treatment.

The researchers enlisted the use of trained physician reviewers in two different situations. The reviewers would either view a patient after 14 days of an unplanned hospital visit or a patient after 14 days of already visiting one or more primary care, hospital care, or urgent care facilities. The physicians were required to diagnose the patient based off of the data compiled from the initial meeting in either situations. The researchers then observed if the treating physician order additional tests due to abnormalities in the original data set or if they simply diagnosed based off of the given information. The data and diagnoses from the primary care physician often influence how a second or third party view the patient and his/her symptoms. 

The study found that 80 percent of the errors resulted from the initial physician-patient meeting when the breakdown of the symptoms and medical issues are discussed. Over 40 percent of these errors were related to two or more breakdowns during the communication process. The researchers concluded that the majority of errors could be traced from the initial bedside conversation as well as the initial physical examinations and tests. Many secondary medical professionals relied on the data that came from the initial encounter between the physician and the patient which resulted in mistreating patients. 

The investigators cited 68 unique diagnostic errors, which included pneumonia, cancer, decompensated congestive heart failure (CHF), and urinary tract infection (UTI) or pyelonephritis which can lead to kidney failure. The study theorized that primary care physicians  can be prone to making more errors because of the increase in variety and complexity of diseases in conjunction with the short time allotted to each patient. Researchers recommend using a generic training method for all physicians in order to decrease the chances of a wrong diagnosis. However, whether or not this form of training will benefit patients and physicians is unknown. 

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