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Missed and Delayed Diagnoses in the Ambulatory Setting
- Eta S. Berner, EdD;
- Randolph A. Miller, MD; and
- Mark L. Graber, MD
- From the University of Alabama at Birmingham, Birmingham, AL 35294; Vanderbilt University, Nashville, TN 37232; and State University of New York at Stony Brook and Veterans Affairs Medical Center, Northport, NY 11768.
TO THE EDITOR:
We applaud Gandhi and colleagues (1) for highlighting the problem of outpatient diagnostic errors. However, malpractice claims are a biased data source. Primary identification of diagnostic errors in ambulatory settings remains problematic.
Wachter (2) highlighted differences that make diagnostic error detection more difficult in ambulatory settings than in hospitals. Outpatient diagnosticians typically record their observations and conclusions incompletely and illegibly on paper charts, which contributes to the lack of knowledge about …
