Hospitals, offices have similar rates of medical errors. (System Failures Faulted).

BOSTON -- Physicians in a private practice setting make a similar number and type of medical errors as their colleagues working in a hospital setting, according to findings of a study presented at the annual meeting of the American Academy of Pediatrics.

Studies on medical errors to date have focused on hospital-based care. Researchers are unsure how to characterize the number and severity of medical errors in private practice. "That's why we did the study" said Dr. Lucian Leape, adjunct professor of health policy at Harvard School of Public Health, Boston.

Although he declined to go into details while the paper is under consideration for publication, Dr. Leape said, "I can tell you the general finding isn't any different. Doctors make the same kinds of mistakes in an office as they do in a hospital."

The study holds some good news for office-based physicians: The severity of mistakes is generally lower. "Medical errors in an office are less likely to be fatal because the patients are not as sick and are not receiving as many interventions" as they do in a hospital, he said at the conference.

Another finding of the study--tentatively titled "Adverse Drug Events in Ambulatory Care"--is that office-based doctors make the same number and type of prescription errors as colleagues in a hospital do. Dr. Leape suggested that computerized prescribing would eliminate the majority of the mistakes that stem from misinterpretation of handwritten drug orders in both private practices and hospitals.

"The big message ... is that no one makes mistakes on purpose," he said. "Even when you're intelligent, capable, and hardworking, you still make mistakes."

The crux of his presentation was that errors are caused by system failures. For example, getting two look-alike medicines confused is a failure on the part of manufacturers to distinguish their products. Failure to schedule a follow-up appointment or interpret laboratory test results can point to inefficiencies in an office setup. Both are system failures.