Coverys Report Reveals Diagnostic Errors Occur Most Frequently in Office-Based Care

August 12, 2025 at 09:25 AM EDT

Analysis of 6,000+ closed medical malpractice claims reveals office-based care is a high-risk setting for missed diagnoses, particularly cancer

Coverys, a leading provider of medical professional liability (MPL) insurance and healthcare risk management services, today released the second report in a three-part series, A Dose of Insight – Hidden in Plain Sight: Exposing the Drivers of Diagnostic Error, Part Two: Office-Based Practice.

Drawing on an in-depth analysis of Coverys medical malpractice claims from 2020 to 2024, the report highlights the ongoing and often underestimated threat of diagnostic errors in office-based practices. It brings attention to critical patterns—such as the frequent occurrence of missed cancer diagnoses—and underscores the need for greater awareness and system-level improvements to support more accurate and timely diagnoses. The report’s key findings include:

Key Findings:

27% of malpractice events closed during the five-year period studied involved diagnostic error.
Diagnostic error occurs most frequently in office-based settings, accounting for 34% of diagnosis-related events.
45% of office-based events alleged a missed cancer diagnosis. The most common missed cancers were prostate, lung, breast, and colorectal.
One-third of office-based diagnostic error events resulted in a patient's death, and 22% resulted in a patient suffering a high-severity injury. Together, these tragic events accounted for 72% of the indemnity paid.

“Improving diagnostic accuracy is one of the most meaningful ways we can enhance patient safety,” said Dana Siegal, RN, CPHRM, CPPS, Vice President, Risk Management and Analytics at Coverys. "Unlike office-based procedures which are generally less urgent and complex than those performed in surgical or labor and delivery settings, diagnostic errors—particularly in outpatient settings—pose an underestimated threat to the safety and quality of patient care. This report provides data-informed actionable guidance to help clinicians recognize and address these risks, ultimately aiming to minimize patient harm."

Understanding and addressing the key vulnerabilities and commonly missed diagnoses identified in this report can significantly reduce diagnostic errors in the office setting. While the data highlights serious challenges, the empirical analysis also offers insights into five practical actions providers can take to enhance diagnostic accuracy and eliminate the hidden drivers of diagnostic errors in office-based care.

The report is the second installment in a three-part series examining diagnostic challenges in three care settings. The series began with an in-depth analysis of emergency departments, where diagnostic accuracy is often compromised by high patient volumes and time-sensitive decision-making. A future report will examine inpatient care and the unique diagnostic risks faced by hospitalized patients and their clinical teams.

In alignment with this important work, the Coverys Community Healthcare Foundation, Inc. (CCHF) is pleased to announce a new grant opportunity focused on reducing diagnostic error and enhancing patient outcomes. Grants will support innovative programs in the following settings: Emergency Department, Office-Based Practice, and Hospital Inpatient Care. For more information and to apply, visit the CCHF Grant Page.

The Dose of Insight report was co-authored by Dana Siegal, RN, CPHRM, CPPS, Vice President, Risk Management & Analytics; Maryann Small, MBA, Senior Director, Business Analytics; Susan L. Montminy, EdD, MPA, BSN, RN, FASHRM, CPHRM, CPPS, Senior Director, Risk Management & Analytics; Marlene Icenhower, BSN, JD, CPHRM, Senior Risk Specialist, Risk Management & Analytics; Patricia Bennett, RN, CPC, Senior Manager Clinical Coding, Business Analytics; Michelle Bondurant, RN, CP, Clinical Data Manager, Business Analytics.

The full report is available at Coverys.com

About Coverys

With close to $4 billion in assets and 50 years of protecting healthcare, Coverys is a leading provider of medical professional liability insurance. Coverys offers a full range of healthcare liability insurance options, complemented by advanced data analytics, evidence-based processes, and best-in-class risk management and education resources. With Coverys, healthcare providers can confidently focus on improving clinical, operational, and financial outcomes. For more information, visit coverys.com.