While I am on the topic of medicine, I want to mention an interesting take on medical mistakes. Harvard School of Medicine’s Dr. Jerome Groopman has written a book entitled How Doctors Think. His book is intended to wake up the medical community to thinking errors that harm patients. He believes that medical schools should begin teaching courses in logic as applied to diagnosing patients. Groopman is considered to be one of the best in his field, but some of the stories of his own thinking errors leave one with perhaps reduced confidence in doctors.
Groopman says that doctors too often hit on the first possible diagnosis that comes to mind and then stick with that diagnosis. They look only for factors that might confirm their initial diagnosis while ignoring factors that might suggest something else.
For example, Groopman related the story of consulting with another doctor while preparing for surgery. He had a series of procedures lined up. He planned to try one after the other until he found the root problem. The other doctor listened and then said, “Maybe he has gout.” At first it seemed preposterous, but after thinking about it, Groopman realized that he had ignored some symptoms and tests. The patient was then treated effectively without having to endure extensive exploratory surgery.
Groopman says that it is important for patients receiving a diagnosis to ask three questions:
1) Is there anything else this could be?
2) Could there be other issues in addition to the main diagnosis?
3) Is there anything in your examination or tests that might be counter indicative of this diagnosis?
Groopman says that this approach will help the doctor think in ways that will produce the best possible outcome. He says that many doctors will not welcome the questions, but that your health is more any doctor’s ego.