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January 31, 1977

Hospitalization for Possible Myocardial Infarction-Reply

JAMA. 1977;237(5):449. doi:10.1001/jama.1977.03270320027013

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When making decisions in the face of uncertainty, physicians, like anyone else, assume a risk of being wrong. When a physician in an emergency room makes a decision, he bases it on all the available evidence, his previous knowledge, and an idea that one type of error—denying admission to a patient who needs it—is worse than the other type—hospitalizing a patient not in need of such hospitalization. A person may be justifiably hospitalized on the basis of the best medical knowledge available and yet by hindsight he may not have needed it.

Dr Berger may infer a pejorative connotation to the word error, but we certainly did not imply it. From the point of view of the physician, he did what every other physician would have done. Even though he is not at fault, it is still an error.