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    Strategies to avoid diagnostic errors


    What to do?

    Dr. Schiff points to two key strategies:

    Situational awareness. To accomplish this, worry about what can go wrong, develop ways to prevent errors, and be open about failures.

    To that end, Dr. Schiff calls for an end to the conspiracy of silence around diagnosis mistakes. There needs to be more error reporting so physicians can learn from each other, he says, and gain more awareness of conditions that are frequently misdiagnosed. “What are the pitfalls,” he says, “the traps that people frequently fall into?”

    READ: Using dermoscopy to enhance diagnostic accuracy

    Create a safety net to make sure that there are opportunities to notice and repair errors. To do this, take advantage of the power of technology to automate processes and ease burdens on staff.

    Unfortunately, Dr. Schiff says, technology is often a hindrance: “Systems are clumsy to learn, they’re distracting, and there’s lot of potential for unintended consequences.”

    As for Dr. Schiff himself, he didn’t let his own misdiagnosis slip quietly into the past. Instead, he tried to get information about the error back to his primary-care physician. But he didn’t seek a confrontation. “The idea is not to fight,” he says. “The idea is to improve.”

    Disclosure: Dr. Schiff reports grants/research funding from MedAware.


    1. Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016;353:i2139.

    Randy Dotinga
    Randy Dotinga is a medical writer based in San Diego, Calif.


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