Some chilling words:
There is no bonus for curing someone and no penalty for failing, except when the mistakes rise to the level of malpractice.
So even though doctors can have the best intentions, they have little
economic incentive to spend time double-checking their instincts, and
hospitals have little incentive to give them the tools to do so…
Joseph Britto, a former intensive-care
doctor, likes to compare medicine’s attitude toward mistakes with the
airline industry’s. At the insistence of pilots, who have the ultimate
incentive not to mess up, airlines have studied their errors and nearly
"Unlike pilots," Dr. Britto said, "doctors don’t go down with their planes."
This article goes on to talk about Isabel, a database for differential diagnosis and symptom matching. I saw it demonstrated at the AAFP Scientific Assembly – it was very cool. I wonder how we would incorporate something like this in Family Medicine, where we "treat common things commonly." If we implemented it with every patient – would that increase testing costs and waste time? If we just used it with "stumpers" – would it be worth it? Or is this a tool for the specialists only?…if we are stumped, we’re supposed to consult anyway. Interesting thoughts.