RT Book, Section A1 Schiff, Gordon A2 Loscalzo, Joseph A2 Fauci, Anthony A2 Kasper, Dennis A2 Hauser, Stephen A2 Longo, Dan A2 Jameson, J. Larry SR Print(0) ID 1190470922 T1 Diagnosis: Reducing Errors and Improving Quality T2 Harrison's Principles of Internal Medicine, 21e YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781264268504 LK accesspharmacy.mhmedical.com/content.aspx?aid=1190470922 RD 2024/03/28 AB Diagnosing patients’ illnesses is the essence of medicine. Patients present to doctors seeking an answer to the question, “What is wrong with me?” Ideally, no clinician would want to treat a patient without knowing the diagnosis or, worse yet, erroneously treat a misdiagnosed illness. From the earliest moments of medical school, the defining quest toward becoming a knowledgeable and proficient physician is learning how to put a diagnostic label on patients’ symptoms and physical findings, and clinicians pride themselves on being “good diagnosticians.” Yet the centuries-old paradigm of mastering a long list of diseases, understanding their pathophysiology, and knowing the cardinal ways they manifest themselves in signs and symptoms, while still of fundamental importance, is being challenged by new insights illuminated by the glaring spotlight of diagnostic errors. Basic internal medicine diseases, such as asthma, pulmonary embolism, congestive heart failure, seizures, strokes, ruptured aneurysms, depression, and cancer, are misdiagnosed at shockingly high rates, often with 20–50% of patients either being mislabeled as having these conditions (false-positive diagnoses) or having their diagnosis missed or delayed (false negatives). How and why do physicians so often get it wrong, and what can we do to both diagnose and treat the problem of delayed diagnosis or misdiagnosis?