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NEWS | February 23, 2017

Reducing Diagnostic Errors focus of 2017 Highman Lecture at UC Davis

(SACRAMENTO, Calif.)

Michael Laposata, a national expert on laboratory quality, including the better use of diagnostic tests and a focus on reducing errors, will deliver the 2017 Benjamin Highman Lecture on “Medical Errors: The Third Leading Cause of Death in the U.S.” The talk is Thursday, March 2, from 5 until 6 p.m. in the Education Building second floor auditorium, 4610 X Street, Sacramento. A reception follows in the lobby at 6 p.m. Register for the event on Eventbrite.

A National Academy of Medicine Committee conservatively reported in 2015 that 5 percent of U.S. adults who seek outpatient care each year experience a diagnostic error. A National Academy of Medicine Committee conservatively reported in 2015 that 5 percent of U.S. adults who seek outpatient care each year experience a diagnostic error.

Laposata, a professor and chair of pathology at the University of Texas Medical Branch in Galveston, has achieved considerable acclaim for his innovative diagnostic management teams and narrative reports. In a recently published editorial in the Archives of Pathology Laboratory Medicine, he wrote that the growing complexity of diagnostic testing, coupled with the increased use of molecular diagnostics, will require more input from pathologists to prevent life-threatening medical errors. He believes that pathologists need to be consulted and involved in communications with patients and their primary care physicians to deliver the best patient care.

“The message to all medical specialists is rather than just guess at test selection and result interpretation, ask questions of pathologists,” Laposata said.

Laposata was a member of the National Academy of Medicine (NAM) Committee that issued a report in 2015 exposing diagnostic errors as a critical yet under-explored area of concern in health care. The report, “Improving Diagnosis in Health Care,” is a follow up to the Institute of Medicine’s 1999 landmark report, “To Err Is Human: Building a Safer Health System.”

The NAM committee reported that most people will experience at least one diagnostic error in their lifetimes, sometimes with devastating consequences, and that these errors may cause harm to patients by preventing or delaying appropriate treatment; providing unnecessary or harmful treatment; or resulting in psychological or financial repercussions. Laposata and the committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional and public health imperative. Part of the National Academies of Sciences, Engineering and Medicine, NAM is a nonpartisan think tank based in Washington, D.C. that advises several government agencies and legislative bodies on health and medicine policies.

Michael LaposataThe growing complexity of diagnostic testing, coupled with the increased use of molecular diagnostics, will require more input from pathologists to prevent life-threatening medical errors.

— Michael Laposata
National Academy of Medicine
Committee member

Laposata also is an advocate for better education for medical students in the practical aspects of laboratory medicine, from selecting the appropriate tests to making the correct diagnoses. He noted that a survey published in Academic Medicine in 2014 found that most medical schools spend an average of only eight hours total teaching such practical skills.

“Team-based health-care delivery needs to be optimized, and medical students and house staff need to be educated in working as part of an interdisciplinary team,” Laposata said. 

Laposata believes a team-based approach also requires that pathologists evaluate and give clinicians feedback about selecting tests, interpreting results and consulting on treatment decisions -– a process he acknowledges would require a change in culture at most medical centers.

Lydia P. Howell, professor and chair of the Department of Pathology and Laboratory Medicine at UC Davis, is hopeful that Laposata’s message will open doors to improved communication between clinicians and pathologists.

“We can help physicians identify which tests will lead to the patient care answers they need, and provide the timely and accurate interpretation that will facilitate improved patient outcomes,” Howell said. “Integrating pathologists as members of the decision-making team is key to improving this process.”

Laposata is the editor of the 2016 textbook “Clinical Diagnostic Tests: How to Avoid Errors in Ordering Tests and Interpreting Results," and he was recognized by the Institute of Quality in Laboratory Medicine of the U.S. Centers for Disease Control and Prevention in 2005. He is the recipient of 14 major teaching prizes and has more than 150 peer-reviewed publications related to his research in fatty acid metabolism and his clinical interests in coagulation and clinical quality.  

The Highman Symposium is an annual lectureship hosted by the UC Davis Department of Pathology and Laboratory Medicine that honors the work of Benjamin Highman, a physician who spent almost 40 years in the U.S. Public Health Service as medical director and as chief of pathologic anatomy at the National Institutes of Health. He was awarded the Willey Medallion and a special citation by the U.S. Food and Drug Administration. In 1985, Highman retired and joined the volunteer faculty at the UC Davis School of Medicine.