FP study highlights ripple effect: Harm flows from simple errors

The next step will be proposing solutions for error reduction in the family physician's office.

By Andis Robeznieks, AMNews staff. Sept. 23/30, 2002.

Much attention has been paid to hospital-based medical errors, but a recent study of the practice setting found that even the most minute mistakes made there can also have far-reaching consequences.

"Common and apparently trivial health system problems in primary care can sometimes harm and even kill patients," said the authors of "A preliminary taxonomy of medical errors in family practice." The study, published in the September Quality and Safety in Health Care, looks at preventing errors in the primary care setting. Previous research has focused mostly on hospital settings.

Noting that Americans visit doctors' offices 820 million times a year compared with the 38 million times they are hospitalized, Richard Roberts, MD, board chair of the American Academy of Family Physicians, said the study was overdue.

"As Americans, we have too often misled ourselves by focusing on the dramatic -- what they call the 'rescue mentality,' " he said. "This study begins to focus us on the beginning of the health care experience: the doctor's office.

"So now, people are going to say, 'What are we going to do about it?' Well, that's a good question," he added. "One of the problems is we don't know what we don't know. We have a lot of work to do."

Susan M. Dovey, PhD, an analyst at the Robert Graham Center in Washington, D.C., who led the study, agreed that too much research had focused on hospitals. But she predicted that this would change.

"All over the world, in the developed countries, people use the terms 'health care' and 'hospital care' interchangeably," said Dr. Dovey, a native of New Zealand. "I think the 21st century will show something different, especially as more and more health care will be provided outside of hospital settings." [...]