Error in anatomic pathology.

Abstract

Error in anatomic pathology is a topic that is currently making the difficult transition from a problem peculiar to a subset of poorly trained or otherwise inadequate pathologists to a problem shared by the specialty of pathology. This transition will involve a number of difficult steps, including sorting error from both inherent diagnostic uncertainty andfrom variations in practice patterns from which no evidence-based best practice has emerged. Identification of error will require scientifically valid diagnostic gold standards, and in those areas of diagnosis without such a standard, the identification of and response to error will continue to be heavily influenced by hindsight bias and subjective opinion. The pathologist, like other physicians, has limited options to "make things right" following a significant error The silver lining is that many errors have the potential to prompt changes that will prevent future patient harm. Unfortunately, a dysfunctional legal system that values punishment and transfer of assets over future improvements in health care has wrung much of the positive potential out of error, leaving only the damaged patient and damaged pathologist.