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Important Questions?

  • 1.  Important Questions?

    Posted 06-12-2020 23:34
    Edited by Amanda Staller 06-15-2020 15:22
    Mark Graber and associates initiative with the Institute of Medicine's report some years ago.

    David Newman-Toker and associates recent article published in Diagnosis, detailing the rate of diagnostic errors for "Big Three" disease conditions and causing serious misdiagnosis-related harms.

    Gordon Schiff's recent John M. Eisenberg Award.

    Peggy Zuckerman's frequent postings that we need to constantly consider patients when errors are made.

    So let me pose a few questions. I would welcome comment and further questions.




    Assuming that one question can lead to another and then another, would more questions asked at all levels in medicine be valuable to patients?

    Could such questions also be valuable to SIDM?

    Is the one thing that holds us from making significant progress with errors in medicine, lack of accurate error data?

    If this is true could negotiations with States as opposed to the Federal Government eventually lead to change?

    Could a survey with international medical organizations asking for their top recommendations that they have found improve/enhance the diagnostic process?

    With all the changes taking pace and yet to come with the Corona virus pandemic is this the time to consider new things and forge new relationships with national and international organizations?

    Are the personal biases in diagnostic medicine likely to be eliminated with the first Artificial Intelligence (AI) programs dedicated to diagnoses?

    In caring for patients are economical, loyalty, and political issues among the most important biases we collectively have?

    Would patients benefit if more retired persons, women, academics, patients themselves, were invited to participate in the running and organization of specialty medical societies?

    Would publishing SIDM position papers from time to time benefit patients?

    Robert M. Bell, M.D.

  • 2.  RE: Important Questions?

    Posted 06-15-2020 09:46

    Hi Bob,

    I really like your idea of SIDM publishing a few position papers.  Many societies are doing that now (I've actually been a co-author on one for the ACR that came out last month).  It is a way for SIDM to be "on record" as having a guideline/directive in a particular are--and is something we can refer to and build upon later.


    Michael A. Bruno, M.D., M.S., F.A.C.R.  
    Professor of Radiology & Medicine

    Vice Chair for Quality & Patient Safety

    Chief, Division of Emergency Radiology

    Penn State Milton S. Hershey Medical Center
    ( (717) 531-8703  |  6 (717) 531-5737

    * mbruno@pennstatehealth.psu.edu  


  • 3.  RE: Important Questions?

    Posted 06-15-2020 10:50

  • 4.  RE: Important Questions?

    Posted 06-15-2020 19:14

    I also think that having position papers on selected topics makes sense.  I would put in the caveat that one must select the topics carefully so that they meaningfully contribute to either new thinking in the field or have something concrete to say about advancing the field. The IOM report is pretty comprehensive and any position papers should not just re-iterate what was already said.




    Michael H. Kanter, MD, CPPS

    Professor and Chair

    Department of Clinical Science


    Kaiser Permanente School of Medicine

    100 S. Los Robles Avenue, 4th floor

    Pasadena, CA  91101

    Work phone: (626) 564-3643 | tieline 8+338 | Mobile phone: (626) 243-8674

    michael.h.kanter@kp.org | @michaelkantermd




    Vanessa Papatsos, Executive Assistant

    vanessa.papatsos@kp.org | Work phone: (626) 564-3608 | Mobile phone: (626) 660-8604



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  • 5.  RE: Important Questions?

    Posted 06-15-2020 19:17
    Another potential avenue would be to incorporate some form of evidence update.
    Especially for rigorously developed estimates like the IOM's, updating how those predictions have played out over the next X years is quite valuable.
    I'm thinking of the impact of such work as: Goldman, Lee, Robert Sayson, Stanley Robbins, Lawrence H. Cohn, Michael Bettmann, and Monica Weisberg. "The value of the autopsy in three medical eras." New England Journal of Medicine 308, no. 17 (1983): 1000-1005.