Diagnostic Error and the Case for the Second Look
Most diagnostic mistakes are not exotic diseases missed. They are common conditions seen through the wrong frame.
Cognitive shortcuts are what make experienced clinicians fast. They are also where diagnostic error hides. Anchoring on the first impression, closing a workup too early, or accepting a handoff diagnosis without question.
Build in the pause
Simple habits help. Ask what else this could be before closing the chart. Revisit the diagnosis when the patient does not follow the expected course. Invite a colleague to look at the case cold.
A second look costs minutes. A missed diagnosis can cost far more.
Dr. Okafor is a general internist and contributing editor who writes about primary care redesign and the economics of the exam room.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
