Emergency room doctors misdiagnose patients with unusual symptoms

“As with all medical specialties, there is room for improvement in the diagnostic accuracy of emergency care,” said Dr. Kang added. “All of us who practice emergency medicine are committed to improving care and reducing diagnostic error.”

Doctors say addressing diagnostic errors is a challenge. Although the National Academy of Medicine identified medical errors as a critical problem more than 20 years ago, most efforts to improve patient safety have focused on errors that are easier to identify, such as when a patient takes the wrong medication or develops an infection while in the hospital, said Dr. Robert Wachter, the chairman of medicine at the University of California, San Francisco, who had not seen the full report. “Diagnostic errors are a big part of the problem,” he said.

The deaths that the report suggests occur each year “is a very worrying number,” said Dr. Wachter said. He noted that the study’s findings are higher than previous estimates.

The researchers relied heavily on studies conducted outside the United States, in countries such as Canada, Spain and Switzerland, to derive their overall estimate of error and harm rates. But Dr. Kang argued that reliance on these studies may have skewed the findings and led the researchers to overestimate the number of errors. “While most medical specialties have similar training in Western nations, emergency medicine does not,” he said.

The study authors acknowledged the need for more research looking specifically at emergency rooms in the United States. “We need studies done in the United States,” said Dr. Susan M. Peterson, an emergency physician at Johns Hopkins who is also one of the authors of the study. “It’s a huge gap in the literature.”

But he also emphasized the benefit of paying more attention when doctors often miss a crucial diagnosis. In recent years, he said, doctors have gotten much better at detecting heart attacks because of a concerted effort that includes public health campaigns, better diagnostic tests and collaboration between cardiologists and emergency physicians to address the problem.

The experts also stressed that while the study focused on those mistakes made in emergency rooms, where a harried doctor, dealing with overcrowding, has to make a quick decision about what to do with a patient, the issue of misdiagnosis is a common problem among all doctors.

Leave a Reply

Your email address will not be published. Required fields are marked *