Why Physicians Make Mistakes

Drawing on his own clinical experience and on academic studies, Cohn explained that about one-third of these errors appear to be products of misdiagnosis, one cause of which is “anchoring bias”: human beings’ tendency to rely too heavily on a single piece of information. This happens all the time in doctors’ offices, clinics, and emergency rooms. A physician hears about two or three symptoms, seizes on a diagnosis consistent with those, and subconsciously discounts evidence that points to something else. Or a physician hits upon the right diagnosis, but fails to realize that it’s incomplete, and ends up treating just one condition when the patient is, in fact, suffering from several. Tools like Watson [the IBM computer] are less prone to those failings. As such, Cohn believes, they may eventually become as ubiquitous in doctors’ offices as the stethoscope.

Jonathan Cohn in The Atlantic. HT: Austin Frakt.

Comments (10)

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  1. Studebaker says:

    Doctors tend to discount computer-assisted decision-support tolls as something less-qualified practitioners (i.e. nurse practitioners, physician’s assistants or nurse call lines) use to supplement their lack of education. But, a doctor cannot retrieve in only a matter of minutes all the knowledge needed to make complex diagnoses. These should be incorporated into all medical practice.

  2. Anthony Sombers says:

    I am definitely in favor of automated medical computers with the ability to provide diagnosis. This does not mean farewell to MD’s, but could make their jobs a lot easier and help prevent malpractice. Nor should this be a substitution for diagnosis, but rather a complement that doctors could use to get a better idea of the direction the diagnosis should take.

  3. Ryan says:

    Well if humans make so many mistakes, then robots ought to be tested. Doubt it’d be much worse than it is now with human mistakes.

  4. Priscilla says:

    It’s very impressive to see that we should expect more from machines than actual people these days. I’ve never been a big believer of robots as doctors. I just think that a machine could never achieve as much detail and depth as a person can. However, it’s reports like this that make me think otherwise. If this is true, then we are closer to finding robots talking to us at the doctor’s office instead of people…very interesting news.

  5. Stephan says:

    To err is human…shouldn’t we give physicians a break?

  6. Bubba says:

    Drawing on his own clinical experience and on academic studies, Kohn explained that about one-third of these errors appear to be products of misdiagnosis, one cause of which is “anchoring bias”: human beings’ tendency to rely too heavily on a single piece of information.

    Is “anchoring bias” anything like “arrogance”?

  7. Dallas says:

    How was this study conducted? Were doctors’ diagnoses compared with machines insofar as final diagnosis?

    It seems as though entering a set of symptoms into a machine and congratulating it when it comes up with one correct answer out of 50 different possibilities is silly. Anyone who’s ever used WebMD knows that in a huge list of possibilities, one is likely to be right but that it takes a human person to judge among the options. It seems that the thing that makes doctors wrong more often is that, unlike a machine, they’re tasked with making this call.

  8. Kyle says:

    An NBER paper just said that we are seriously over estimating the value of HIT in hospitals. Even systems with percentage based procedural recommendations. Great.

  9. Hoover says:

    A few posts back they said if the NHS accidentally nips off the wrong testicle during a procedure you only get 20k pounds in compensation.

    Two questions:
    What is that in real money?
    What is a T worth in ‘merica?

  10. Gabriel Odom says:

    It seems we have a great deal of logical fallacies in these comments…

    First off, anyone who compares WebMD (a free website) to one of the most advanced computers in the history of existence is deficient in multiple levels of reasoning.
    Secondly, nowhere in the article does Cohn even mention the idea that he believes robots will replace all doctors. Robots are tools for doctors to use, including the marvellously advanced DaVinci surgery system ( http://en.wikipedia.org/wiki/Da_Vinci_Surgical_System ). Cohn said “Think Dr. McCoy using his tricorder to diagnose a phaser injury on Star Trek, not the droid fitting Luke Skywalker with a robotic hand in Star Wars.”
    Thirdly, the NBER overvalued HIT in hospitals because not all HIT was ready. The HITECH Act forced hospitals to choose between good and poor software, without even knowing which was which. HIT firms have made a killing in the past five years, and most of these products are more trouble than they’re worth. Unfortunately, now we just wait for the market to correct itself, and for the quality of these EHRs to improve.
    Lastly, 20k pounds sterling is 30k US. A similar lawsuit in the U.S. was for 200k.