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Unraveling the Gordian Knot

When your child has been ill for a long time, and you feel that his doctors have failed him; when you feel betrayed and dismissed by the very people you turned to for help, it's hard to believe that anyone in the medical establishment truly cares. Instead of hands reaching down to help you rise from the muck of misdiagnosis, you see the palms of surrender, the shrug of shoulders, the glint of irritation that you've returned, again, to ask for answers.

So you can imagine my joy at finding a community of doctors, researchers, hospital directors, and administrators who are determined to solve one of the most complex challenges in medicine today: to unravel the Gordian knot that is the diagnostic process when it fails. Not to simply cut it, so the threads are unusable for any other purpose, but to do the daunting work of identifying causes, designing solutions, testing them in their own organizations, and then sharing what works so others may benefit.

Today, at the first Interventions to Improve Diagnosis meeting, I worked with men and women with the glint of determination in their eyes, their shoulders set to lift, their palms held out to grasp. Approximately 35 experts from health care systems all over the country met because we want to improve the accuracy and speed of diagnosis. Six teams from hospital systems, a handful of advisers, and staff from SIDM (the Society to Improve Diagnosis in Medicine) and IHI (the Institute for Healthcare Improvement) have decided to try.

They're not alone. By Sunday, hundreds more will have come to Boston from all over the world to attend the 10th International Diagnostic Error in Medicine conference convened by SIDM. They're ready to attack the formidable task of unraveling the knotted rope, and then using it to pull so many others to safety.

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