Why We Make Bad Decisions
Physicians do get things wrong, remarkably often. Studies have shown that up to one in five patients are misdiagnosed. In the United States and Canada it is estimated that 50,000 hospital deaths each year could have been prevented if the real cause of illness had been correctly identified.
Yet people are loath to challenge experts. In a 2009 experiment carried out at Emory University, a group of adults was asked to make a decision while contemplating an expert’s claims, in this case, a financial expert. A functional M.R.I. scanner gauged their brain activity as they did so. The results were extraordinary: when confronted with the expert, it was as if the independent decision-making parts of many subjects’ brains pretty much switched off. They simply ceded their power to decide to the expert.
When we find data that supports our hopes we appear to get a dopamine rush similar to the one we get if we eat chocolate, have sex or fall in love. But it’s often information that challenges our existing opinions or wishful desires that yields the greatest insights.
The dangerous allure of the information we want to hear is something we need to be more vigilant about, in the medical consulting room and beyond.
Interesting article via NYTimes, read the entire story:
http://www.nytimes.com/2013/10/20/opinion/sunday/why-we-make-bad-decisions.html?pagewanted=1&_r=0
Diagram by Wendy MacNaughton
That is the reason medical malpractice lawyers are making big bucks...
ReplyDeleteMatt B you hit the nail on its head. The lack of a peer-review system makes the doctor system look like much as a religion: just have faith.
ReplyDeleteI had some animated discussions with medical doctors in the past trying to show them how primitive the medical diagnosis process currently is; it is highly conservative and resistant to change. It follows similar steps as Proxenus of Atarneus was following, with the difference of having more information available (thanks to other areas of science).
In most places diagnosis is just guess work, a wave in finding root-cause (just take an aspirin) or real time experimentation (let's try this; come back if it did not work or if you are not dead) ... where patients risk themselves of get unnecessary damage.
Why not apply diagnosis as a double-blind diagnosis / study, where experimenter bias and placebo effects are greatly reduced? Why not gather frequent baseline values from the patient to determine later if something is a real problem or a normal fluctuation, allowing the individual to compare with the healthy version of himself instead of a random selected population? Why not depersonalize health data and let Universities build case studies out of them and compare results between different institutions, seeking for objectivity and feed these results back to the patient? Why don't health systems keep track on population knowledge (obligatory individual inquiries) in order to determine what to focus in educating the population on simple health related practices / procedures and have the perception of risk areas or situations (mentioned by Christian Visscher )?
Matt B not at all. I actually found your comment optimist. My comment in contrast is the pessimist version.
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