A recent survey of more than 700 pediatricians and trainees (residents and fellows) found that more than half admitted to mis-diagnosing a child once or more every thirty days. That included more than 77 % of the pediatric trainees. The most cited omission was failure to diagnose a bacterial infection or viral illness that may call for antibiotics. These diagnostic errors have various causes, but the report indicated that the most common include a doctor’s failure to properly gather a patient’s medical or exam history, errors on medical charts, and failure to follow up on abnormal test results. Other common missed or mistaken diagnoses include those involving medication side effects, psychiatric disorders, appendicitis, asthma and ear infections, according to the study.
Even more startling is the fact that these physicians admitted that one or more of these misdiagnoses could have resulted in substantial harm to the patient. Physicans cited several improvement initiatives that would reduce errors which include the following:
- Improved team work and communicationamongst medical staff.
- Additional time spent with patients during appointments.
- Improved access to information through electronic medical records.
- Additional support tools for diagnosis.
The study continued to focus as well on parental supervision of their child’s medical care by citing other causes of misdiagnoses to includ failure of parents to seek care for their child in a timely manner, failure to follow-up on abnormal lab tests and parents ignoring follow-up recommendations. The antiquated means of delivering medical care was an additional factor for mis-diagnosis aknlowleding that lack of knowledge was not the issue rather the lack of systems and protocols in place similar to that which are applied in the automotive or airline industry. That includes clinical practice guidelines that offer evidence-based, standardized approaches to problems; greater reliance on checklists to ensure proper steps were followed in making a diagnosis; comprehensive electronic health records that automatically flag pediatricians about prescription errors (such as dosage or drug interactions) or remind doctors about tests that should be scheduled and followed-up on.
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