We hear about so-called “never events” such as wrong-side surgery or lethal drug overdoses in the media quite a bit. However, according to a recent study in BMJ Quality & Safety , Tehrani and colleagues found that “diagnostic errors appear to be the most common, most costly and most dangerous of medical mistakes” Moreover, they say the “diagnostic errors resulted in death or disability almost twice as often as other error categories.” They conclude that “healthcare stakeholders should consider diagnostic safety a critical health policy issue.” (Who isn’t a healthcare stakeholder? As potential patients, we are all stakeholders!)

There are many reasons for diagnostic error, and (perhaps surprisingly to some) they usually do not involve physicians’ lack of knowledge or training. Instead, psychological influences (such as subconscious bias, framing, loss aversion, or other factors) on decision making behavior result in cognitive error, which has been estimated to play a role in up to 75% of diagnostic error. Clearly, this IS a critical patient safety issue. We should all be paying more attention to this developing paradigm.

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