This presentation will examine various psychological features associated with the persistence of diagnostic error, especially ones that involve 1) The intersection of diagnostic error with the discomfort of uncertainty, 2) The reluctance of physicians to admit uncertainty, 3) The cultivation of overconfidence as a compensatory mechanism for the unpleasantness of uncertainty, and 4) The resulting inertia as a (non)response to remediating system issues that invite or enable diagnostic error.

Additionally, we will discuss the role of overconfidence as a response to production pressures, as well as the phenomenon of few if any feedback mechanisms built into care delivery systems that might reduce the frequency of errors, mistakes, oversights, misses, etc.