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Updated by Thomas Masterson on Jan 11, 2017
Headline for Iatrogenesis Imperfecta - Accidental patient harm inflicted by doctors
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Iatrogenesis Imperfecta - Accidental patient harm inflicted by doctors

"The daily thought list should prevent the most common causes of iatrogenic patient discomfort." The original list was published in 1992 in the Intern Pocket Survival Guide by Tom Masterson. The original list items are numbered.

Some issues are now receiving institutional attention such as the foleys and nephrotoxic medications. Other issues remain broken 24 years later.

Please add your 21st century issues. The original list was collected from real patients during rounds at a University Medicine Program. Think about what subtle issues might be overlooked if you don't make a conscious effort to include them in your daily thought process. Vote up issues that you think are of greater concern, and vote down issues that you think are solved at your institution.

Thanks, TM


Fluid overload from forgotten IVs. (1)


Not recognizing respiratory distress because it had been ignored by an earlier shift. (7)


Not recognizing sepsis because charted vital signs look rosier than the patient. (8)


Your marriage to the admission diagnosis obscures findings that point in other directions. (9)


Not considering pulmonary emboli in differential diagnosis. (10)


Incomplete or incorrect home medication list.


Hypokalemia. (2)


Impaction. (3)


Urosepsis from old foleys. (4)


Failure to adjust drug dosages for renal failure. (5)


Losing track of aminoglycoside or vancomycin levels. (6)

  • Tom Masterson, M.D. loves He is Medical Director of the American Association of Hospitalist Directors. He also serves as an editor at and Chairman of Medicine at Medstar Southern Maryland Hospital.

    Dr. Masterson is a graduate Harvard College and the University of Virginia Medical School. He is the author of the popular pocket books for doctors called “The Intern Pocket Survival Guides.” Even actor-doctors on the TV show “ER” carried around the pocket guides. Dr. Masterson co-authored over 60 titles and launched a number of websites. His team created which is the #1 website for the dialysis industry and is now owned by Davita.

    Today, you can see some of Dr. Masterson's inroads in social media with and The common thread in publishing online or in print -- Dr. Masterson's enormous empathy for beginners whether social, medical, or professional.

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