Wednesday, July 18, 2012

Doctor bias and experience

At one time there was the adage that you shouldn't get sick in July because that is when the new residents come out of medical schools and everyone is on vacation so you are stuck with the newbies. I have had my share of newbies. They are pretty recognizable. But what if lack of experience is not the problem for the established doctors but they can unconsciously be biased in their decisions.

I had never thought of this one but it is pretty clear from this article it can be a real problem. Read down to the second half of the article to see these:

"Anchoring bias, which causes doctors to lock onto a diagnosis early and disregard new and conflicting information. For example, a patient may be diagnosed with a quickly fatal cancer, but then ends up trying various (ineffective) herbal remedies and lives for 30 more years. Instead of considering whether the initial diagnosis was incorrect, the patient — and maybe even the doctor — may falsely assume that the herbal remedies cured the cancer.

Availability bias, when clinicians tend to think that the patient they are treating today has the same condition as the patient they treated last week. Imagine your doctor saw a rare, life-threatening illness last week that presented with a common symptom, such as belly pain. Today, you're in the doctor's office for belly pain, and your doctor may be unjustifiably concerned that you too have that rare life-threatening disease just because she's still thinking about it.

Confirmation bias, which causes doctors to believe evidence when it supports their pre-conceived opinion, while ignoring evidence that contradicts it. For example, let's say your doctor is pretty certain that you have an infection and orders a test to confirm the suspicion. The test is negative for infection, but she treats you for it anyway because she doesn't believe the test results; meanwhile, she disregards clues that point to another, correct diagnosis.

Commission bias, when doctors err on the side of doing something — like ordering a prostate biopsy — as opposed to watchful waiting because it seems that doing something is better than a doing nothing."

So what can you as the patient do? Ask questions, make sure things make sense to you. If you feel your doctor is biased discuss their diagnosis - ask why they think you have that ailment and what needs to be done. Why should or shouldn't you have that procedure or test? Its your job to speak up and talk to your doctor.

If you put this into context, we can all say we have had the same kind of bias in our decisions on a daily basis. But when its our health that is affected it can be a matter of life and death.

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