Development of consultation-liaison psychiatry as dynamic key for decreasing legal cases

Abstract

The incidence of medical slipups in primary care is not rare and the likelihood of faults producing grave harm is great. ‘Misdiagnosis’ means the improper diagnosis of a morbid condition. On the other hand, while patient’s safety is vital in patient care, there is a shortage of studies on medical errors in primary care settings. Anyhow, the most common errors usually are those related to delayed or missed diagnoses, followed by management inaccuracies. Whereas about one percent of hospital admissions result in an adverse event due to negligence, faults are probably much more common, because these studies detect only errors that led to computable adverse events occurring soon after the slips. Differences in healthcare provider teaching and practice, blurred lines of power of doctors, nurses, and other care providers, poor communiqué, incoherent recording systems, overestimation of insufficient data, failure to recognize the frequency and significance of medical errors, sleep deficiency and night shifts, unfamiliar settings, doctor’s depression, fatigue, and burnout, diverse patients, and, lastly, time pressures have been accounted as important bases of medical fault. So, careful medical checkup, based on acceptable clinical abilities and knowledge, is required for analysis of medical problems, especially in view of therapeutic golden-time. Moreover, supplementary and all-inclusive instructive courses, for upgrading the skills and knowledge of medical students in the field of ‘somatic symptom disorder’ and consultation-liaison psychiatry conceivably is valuable for diminishing misdiagnosis or negligence. Current medical teaching and tryout can not discount the vital role of liaison-psychiatry in present-day clinical practice, since the mutual connection between mind and body is more complex than what was thought before in primary care setting.