Misdiagnosis and failure to diagnose in emergency care: Causes and empathy as a solution

Patient Educ Couns. 2020 Aug;103(8):1650-1656. doi: 10.1016/j.pec.2020.02.039. Epub 2020 Feb 28.


Diagnostic error is the most frequent cause of allegations of negligence in emergency care in the United States and is estimated to contribute to the death of hundreds of thousands of patients worldwide each year. In this special contribution, we elucidate the cognitive mechanisms that emergency physicians use to make decisions and identify how these mechanisms can become sources of diagnostic error. The discussion centers on the appraisal of proposed methods to reduce the risk of diagnostic error, including debiasing strategies and a brief discussion of the theoretical basis for interventions to improve clinician empathy.

Keywords: Clinical reasoning; Empathy; Harm reduction; Medical error; Medical malpractice; Negligence.

MeSH terms

  • Diagnostic Errors / statistics & numerical data*
  • Emergency Medical Services
  • Empathy
  • Humans
  • Malpractice
  • United States