Expert Intuition Is Often Wrong

by Hal Mooz 16. April 2014 20:10

Misdiagnosed: Docs' Mistakes Affect 12 Million a Year

t least one in every 20 adults who seeks medical care in a U.S. emergency room or community health clinic may walk away with the wrong diagnosis, according to a new analysis that estimates that 12 million Americans a year could be affected by such errors.


That means patients with conditions as varied as heart failure, pneumonia, anemia and lung cancer could have serious problems that remain unrecognized by a doctor, according to the study published Wednesday in the journal BMJ Quality and Safety.

Quantifying such errors has been difficult, largely because researchers don’t all use the same definition for mistakes and it’s hard to track cases across multiple providers over time.

What they found was that in a little more than 5 percent of cases, the original diagnosis was wrong — and could have been accurately detected by the information available in the first setting.

Previous studies had hinted that the rate of outpatient misdiagnosis might be that high, or even higher. In fact, Dr. Gordon Schiff, a patient safety expert at Brigham and Women’s Hospital in Boston, said that he believes Singh’s work probably underestimates the actual scope of diagnostic errors.

The reasons outpatient doctors miss correct diagnoses can vary widely, Singh said. Time with patients is more limited than ever and their symptoms are often complex and evaluated in what he described as "a fairly chaotic outpatient environment." Many doctors lack the support and technical help that could free them to use good clinical reasoning consistently, he added.


"This is an important finding and validates the level of safety and quality issues in outpatient settings," she said. "We know people are getting more care in outpatient settings than in the past. There needs to be more scrutiny on what they're doing and pressure to improve their performance. Misdiagnosis can have a significant impact on patient outcomes and could result in harm."


Emotional Decision With A Permanent Outcome

by Hal Mooz 16. April 2014 10:29

Denver Woman's 13-Minute-Long 911 Call Ends With Fatal Gunshot

A Denver woman who spent nearly 15 frantic minutes on the phone with a 911 dispatcher was killed Monday night by a bullet to the head before help arrived.

Kirk's husband, Richard, 47, was arrested on suspicion of first-degree murder, Lopez said. He appeared in court Wednesday, waived his formal advisement, and will remain in custody. In her call to 911, Kirk said her husband was "talking about the end of the world and he wanted her to shoot him," according to a probable cause statement filed in the case. There was a gun in their house, Kirk said at the beginning of the phone call, but it was locked in a safe.

As the call went on, Kirk told the 911 dispatcher that her husband was hallucinating, scaring their three young children, the court document said. Then, when she saw her husband had gone to the safe and gotten the gun, she started screaming. The sound of a single gunshot reverberated on the call, and Kirk wasn't heard from again.

When officers arrived, they found Kristine Kirk lying on the floor with an apparent gunshot wound to the head. She was pronounced dead at the scene. Police are investigating the possibility that Richard Kirk — who admitted to killing his wife on his way to the police station, according to the probable cause statement — took marijuana prior to the shooting.


Decision Type - Can Something Bad Happen?

by Hal Mooz 12. April 2014 09:07

The 'Rebel Heart' Parents Want To Show Their Daughters The World. The Risks Are Worth It.

My husband and I are raising a child while traveling aboard our 40-foot sailboatCeilydh. The world has two types of responses to our parenting choice: “Lucky kid!” and “That’s crazy!”

The crazy chorus is loud and angry after a fellow cruising family underwent very public rescue this past weekend. Sailors Eric and Charlotte Kaufman were sailing their vessel, the Rebel Heart, from Mexico to New Zealand with their young daughters Lyra, 1, and Cora, 3, when, 900 nautical miles from Mexico, they made an emergency call to the Coast Guard after their youngest daughter became seriously ill and the boat’s power and steering malfunctioned.

As the rescue played out in the news, with the Navy and the National Guard both stepping in, many questions were raised: Who should pay for the no-doubt costly rescue of this family? Did the Kaufmans have enough training for this big trip? And, most of all, what were they thinking taking their young daughters on such a risky adventure?

(What about the rescuers that were put at risk?)


About Hal Mooz

Engineer, Project Manager, Entrepreneur, Author, Trainer, Lecturer, Thought Leader, Consultant

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