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How a Rheumatologist Thinks: Cognition and Diagnostic Errors in Rheumatology
The Institute of Medicine has reported that each year up to 98,000 deaths result from iatrogenic injury and error.1 Autopsy series have suggested a 15% error rate in the practice of medicine. These numbers are surprising and concerning and raise important questions about how we practice medicine. What kind of errors do we make as…
Ethics Forum: A Physician’s Medical Error & the Patient’s Right to Know
Case Ms. A is an 82-year-old woman who presented to the rheumatology office for evaluation of osteoporosis. She had been diagnosed with postmenopausal osteoporosis at age 62 after sustaining a right wrist fracture. She was started on alendronate 70 mg weekly and reported medication compliance. At age 79, she sustained an atraumatic right femur fracture….
Diagnosis of Acute Gouty Arthritis Obscured by Anchoring Bias
A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
Measuring & Preventing Diagnostic Errors
In a December 2019 editorial in the Journal of the American Medical Association, the implications of diagnostic error were explored through the story of two parents, both medical professionals, who sought a diagnosis for their sick child.1 Their son saw specialist after specialist and underwent repeated procedures, but for years was left without an explanation…