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Comment & Response
November 11, 2013

Administrative Overload as a Cause of Diagnostic Error

Author Affiliations
  • 1Bethel Medical Group, Bethel, Connecticut
JAMA Intern Med. 2013;173(20):1927. doi:10.1001/jamainternmed.2013.9743

To the Editor In their Invited Commentary, Newman-Toker and Makary1 mentioned several important reasons why diagnostic errors occur. But they did not mention one reason that has taken on increasing severity in the past few years. I refer to the excessive amount of administrative drudgery that results from filling out forms for insurers, Medicare, Medicaid, pharmacies, visiting nurse agencies, home health care companies, and numerous other entities. These intrusions continue throughout the day and they are a serious distraction. These intrusions decrease physicians’ diagnostic abilities to sort through patients’ symptoms and physical signs and come up with reasonable diagnostic possibilities. All physicians are vulnerable to the dangerous effects of this “administrative overload.” Although the name may sound comical, the effects are not. Besides leading to diagnostic error, administrative overload causes burnout, loss of enthusiasm, and loss of job satisfaction. Medical leaders should consider administrative overload as a serious and growing cause of medical error.