General Medicine: Diagnostic Risk Across the Continuum of Care

General medicine represents a significant area of medical professional liability (MPL) exposure, accounting for 9% of asserted cases in the Candello database from 2016–2025. Diagnosis-related allegations predominate, while patterns in contributing factors and care settings point to vulnerabilities that can develop across multiple encounters and throughout the diagnostic and treatment process.

Why this Matters?

Diagnostic Risk Is Both Frequent and High-Impact
Diagnosis-related allegations account for 48% of asserted general medicine cases, far exceeding other allegation categories. Patient assessment—the processes involved in evaluating, monitoring, and responding to a patient’s clinical condition—is also the most frequently identified contributing factor, present in 64.5% of cases. The consequences can be substantial: 39% of asserted general medicine cases involve patient death, and diagnosis-related cases have the highest average total incurred among the leading allegation categories. These findings demonstrate how breakdowns in assessment, diagnostic reasoning, and follow-up can translate into significant patient harm and MPL exposure.

What this Means?

Risk Accumulates Across the Outpatient Care Continuum
With 68% of general medicine cases arising in ambulatory settings, risk often develops over time rather than during a single episode of care. Evolving symptoms, abnormal test results, treatment response, referrals, and information exchanged among multiple providers can each introduce opportunities for missed or delayed action.

For healthcare organizations and MPL insurers, these patterns highlight the importance of looking beyond individual diagnostic decisions to the systems that support longitudinal care. Reliable test-result and referral management, mechanisms for reassessing unresolved symptoms, effective communication across care teams, and documentation of clinical reasoning can help address vulnerabilities before they contribute to patient harm and subsequent claims.