Inadequacies of physical examination as a cause of medical errors and adverse events: a collection of vignettes.
There is a growing concern that lack of emphasis on performing the physical examination will lead to diagnostic errors. This study asked physicians to report cases of oversights in the physical examination which contributed to missed or delayed diagnosis. The majority of incidents reported were errors of omission in which the entire examination was not performed, with smaller proportions reporting misinterpretation or failure to conduct a specific aspect of the examination. Respondents reported delays and failures in diagnosis as well as significant instances of over-treatment and increased cost. This underscores the need to emphasize the importance of the physical examination in medical education and practice as a patient safety strategy. The lead author, Dr. Abraham Verghese, discussed the importance of physical examination in a past AHRQ WebM&M interview.