Everyone thought the AAFP didn’t have any guts. They thought there were a sellout. They said the AAFP never takes a stand. Well, the AAFP has had enough and came out swinging. They are tired of being the poster child for supporting every bureaucratic mistake that has destroyed the lives of their members. This time they mean business. What business? Oh, shame on you. You haven’t heard? The AAFP backs efforts to ensure an accurate diagnosis. Wow. For a while there was information that they were backing inaccurate diagnoses but alas, in a last-minute, 11th-hour meeting they did an about face and said collectively, “Well, f%ck it, we’re tired, let’s just go with the accurate diagnoses” and the rest is history.
Okay, I obviously made that up….or did I? The following is another interpretation of the events. Which is more ridiculous?
Obstacles to Diagnostic Accuracy
Members of the Coalition to Improve Diagnosis have collaborated for months to identify initial obstacles they think impede diagnostic accuracy, such as:
- Incomplete communication during care transitions — When patients are transferred between facilities, physicians or departments, there is potential for important information to slip through the cracks.
- Lack of measures and feedback — Unlike many other patient safety issues, there are no standardized measures through which hospitals, health systems or physicians can understand their performance in the diagnostic process to guide improvement efforts or to report diagnostic errors. Providers rarely get feedback if a diagnosis was incorrect or changed.
- Limited support to help with clinical reasoning — With hundreds of potential explanations for any one symptom, clinicians need timely, efficient access to tools and resources to assist in making diagnoses.
- Limited time — Patients and their caregivers overwhelmingly report feeling rushed by limited appointment times, which poses real risks to gathering a complete history that is essential to formulating a working diagnosis; such time constraints also allow scant opportunity to thoroughly discuss any further steps in the diagnostic process and set appropriate expectations.
- The diagnostic process is complicated — There is only limited information available to patients about which questions to ask, who to notify when changes in their condition occur or what constitutes serious symptoms. It’s also unclear who is responsible for closing the loop on test results and referrals and how to communicate follow-up.
- Lack of funding for research — The impact of inaccurate or delayed diagnoses on health care costs and patient harm has not been clearly articulated, and only a limited amount of published evidence exists to aid in identifying what improves the diagnostic process.
They collaborated for months? To get these recommendations? They must know this is just a circle jerk that no one will do anything about, right? Nah, I will go with my interpretation.