Does time pressure have a negative effect on diagnostic accuracy?
Diagnosis is a critical area of patient safety. Prior research demonstrates that physicians perceive time pressure as an impediment to diagnosis, but this has not been objectively documented. This educational simulation study examined the ability of internal medicine residents to correctly diagnose written cases with and without time pressure. Residents under time pressure had reduced diagnostic accuracy, and this decrement was more marked for difficult cases. These results demonstrate the benefit of allowing physicians more time for accurate diagnosis, consistent with recent Institute of Medicine recommendations to examine novel models of care and reimbursement to foster diagnostic safety. A recent PSNet interview discussed diagnostic errors and how to reduce them.