The major medical issues of 2017

Periodically we should reflect on what challenges face patients and physicians.  Over the past few days I have worked on a list of the issues that concern me the most.  I welcome suggestions for expanding the list. Diagnostic errors – all patient care requires that we make the proper diagnosis.  Too often we make errors.  A recent paper estimated that 30% of cellulitis admissions did not have cellulitis.  A similar paper found almost the same estimate for community acquired pneumonia admissions.  The most common reason for successful malpractice claims is diagnostic errors.  Have they increased?  Members of the Society to Improve Diagnosis in Medicine believe that we have both systemic and cognitive problems that lead to diagnostic errors.  Some of the systemic problems are addressed later in this list. One most important problem is the requirement that the patient has a diagnosis prior to admission.  As an academic hospitalist, working at a community hospital and VA, I see patients who have a diagnostic label without sufficient information to attach a label.  Too often this leads to diagnostic inertia.  When we allow that to occur, we have both a system error and our own cognitive error. Documentation requirements and EHRs – CMS, in a classic bureaucratic inane solution to some physicians overcharging, developed an indecipherable, illogical set of expectations in routine notes.  Our notes have become unreadable, and the key aspects of a good note &#...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs