6 1GT Tuesday August 11 2020 | the times

bodyhealth&soul

diagnose her. The case haunted her

for years. Talking on a video call from

New York, she says she could not

pinpoint what went wrong. “As a

general doctor you’re in a minefield

with every patient who comes in. I had

a patient today and he’s got a ton of

vague complaints. Any one of those

could be something serious, but if I

really worked up every single one we

would have had an eight-hour visit.”

She accepts that one day her

inability to check out every reported

Why doctors make

mistakes — and

the questions you

should ask yours

After Danielle Ofri missed a patient’s cancer she

began researching what can be done to prevent her

profession making errors. By Damian Whitworth

A

few years ago Dr

Danielle Ofri took

a sabbatical from

her hospital and

while she was away

another doctor

looked after her

patients. When she

returned, the doctor told her about a

69-year-old woman whose anaemia

had not been properly explored when

she was under Ofri’s care.

Her colleague had sent the woman

for tests and discovered that she had

multiple myeloma. “My gut bottomed

out to my ankles,” Ofri later wrote.

“I’d missed a cancer.”

Doctors make mistakes, of course

they do. But because of professional

pride, and wariness of tribunals and

negligence claims, they don’t tend to

race to admit them. Ofri’s honesty

feels refreshing, but she denies that

there is anything bold about admitting

to her errors.

“People think there’s some huge

bravery in there, but owning up about

your mistake, that’s the easy bit. It’s

the fixing it that’s hard. If you’ve

got hours I could keep talking about

all my errors. I’ve got tons.”

Ofri is a clinical professor of

medicine at New York University

and practises at the city’s Bellevue

Hospital. She is the author of several

books, including What Patients Say,

What Doctors Hear and What Doctors

Feel. The idea for her latest book,

When We Do Harm, came from an

article published in The BMJ in 2016

saying that medical error was the third

leading cause of death in the US,

accounting for more than 250,

fatalities a year.

Ofri was confused. She did not see

such deaths in her clinical practice

anywhere near as often as those from

heart failure or lung cancer. “Are we

clinicians killing our patients at an

unprecedented rate and somehow

remaining blithely unaware?” she

writes in her new book.

Her view, after examining the data

and research, is that the “third leading

cause of death” claim is overstated, but

that medical errors are more prevalent

than we think. “The ones we see,

that’s easy. But there is a huge iceberg

under the water that we’re not seeing.

The near-misses, the hidden ones, the

ones we don’t talk about.”

Doctors’ diagnostic accuracy is

estimated to be about 90 per cent.

On days when Ofri is amazed that

overstretched doctors get anything

right, that sounds good. In

cooler-headed moments she finds

the 10 per cent of erroneous diagnoses

to be “disturbing”.

The woman with multiple myeloma

died five years after Ofri failed to

We ’r e

flying

blind so

much of

the time

and it’s

really

terrifying