Study looks at in-office errors by family physicians

Doctors have differing ideas of "patient harm."

By Andis Robeznieks, AMNews staff. April 12, 2004.

Patient safety isn't just for hospitals anymore. That's the message of Nancy Elder, MD, at the University of Cincinnati's Dept. of Family Medicine. Her recent study on medical errors by family physicians found that errors or preventable adverse events occur in almost one-quarter of all patient visits, and almost one-quarter of these incidents lead to patient harm.

Dr. Elder's study, published in the March/April Annals of Family Medicine, examined 351 patient visits to 15 family physicians at seven offices in urban, suburban and rural settings in the Cincinnati area.

Although the sample size was small, she said the study is important because there is still so little published research regarding medical errors in the primary care setting.

"It was very imperfect, but it's a first guesstimate about how common are these process and latent errors in the doctor's office," Dr. Elder said.

She added that interviewing each doctor about each error led to the discovery that physicians do not have a common understanding of what constitutes "patient harm."

"We talked to 15 different doctors and got 15 different definitions," she said. "So we said this is something we clearly need to understand better."

Examples of harm included physical discomfort, a mild adverse drug reaction, moderate physical injury and progression of disease. The most frequent examples, however, were causing the patient increased emotional distress and wasting the patient's time, although not all physicians felt these met the definition.