Doctors Are Wrong More Often Than They Think

From where I sit, the "make or break" point in the practice of medicine probably rests sometime early on during interactions between the patient and doctor when assumptions are often made on both sides of the desk. Nevertheless, a good doctor relies not only on what a patient tells him or her, but also on the details his keen eye observes. Why? What a patient may be telling his or her doctor may be far different than what's really happening.

At least, that's the way it ought to work...

An interesting piece I read in this week's British Medical Journal casts doubts on that process, due to the rapid decisions a doctor must often make, either because of a medical emergency or the need to see many patients in a limited time. Besides the biases doctors already bring with them, those quick decisions, aided by heuristics -- strategies that provide shortcuts leading to those judgments -- can often be wrong, perhaps at the cost of your health.

The author identifies five different traps doctors can fall into. I urge you to consider these mindsets and how they may affect your doctor's opinions and, consequently, your life:

  • The representativeness heuristic assumes something that seems similar to others in a certain category is itself a member of that category.
  • The availability heuristic places greater weight on examples of things that come to mind easily, perhaps because they are easily remembered or recently encountered.
  • Most are poor at assessing the gaps in their knowledge, and tend to overestimate both how much we know and how reliably we know it, thus making doctors much more confident than they should be.
  • The tendency to look for and hold onto information that fits pre-existing expectations. (And, anything that contradicts those assumptions is likely ignored or dismissed as trivial.)
  • The illusory correlation means the tendency to perceive two events as causally related, although the connection between them is coincidental or even non-existent.

Combine toxic drugs and needless medical procedures with faulty assumptions and the recipe for today's health care paradigm in disarray is complete. That's why I remain so dedicated to my vision for a better future for health care, focusing on treating a patient's symptoms rather than attempting to cure them.

British Medical Journal Vol. 330, April 2, 2005: 781-783 Full Free-Text Article

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