Tuesday, July 26, 2011

Representative Heuristics made by Doctors

Do doctors make the same mistakes in their thinking that Sunstein, Thaler and Shiller (and many others) say we all make?  According to an article written in the New Yorker (1/29/2007) by Jerome Groopman...sadly they do. Groopman states that doctors have two or three diagnoses within minutes of meeting with the patient. The minute they walk into the room they are assessing your appearance, complexion, the way you hold your head, movements of the eyes and mouth, the way you sit or stand and your breathing.  They make their diagnoses on "short-cuts or rules of thumb, known in psychology as heuristics." These heuristics or quick judgements can be the cause of "grave errors."   Another mistake that doctors make is the representativeness error being influenced by what is "typically true."  Doctors also can use what is known as the availability heuristic which is the tendency to judge the likelihood of an event by the ease with which relevant examples come to mind.  Then they rely on a confirmation bias which is finding problems that confirm what they expect to find by selectively accepting or ignoring information.  They also can fall victim to what Shiller (last nights blog) calls wishful thinking or affective error in which a decision is based on what they wish were true because they like you or you remind them of themselves or they know you well. 
Studies are being done on the way doctors think with a new field of study in this area.  Groopman argues that doctors may not be the "dispassionate and rational actors that we think they are."  Instead, doctors are susceptible to emotion and biases and make cognitive errors in judgement.  Groopman quotes Dr. Croskerry (head of Dartmouth General Hospital) stating "currently in medical training, we fail to recognize the importance of critical thinking and critical reasoning. The implicit assumption in medicine is that we know how to think. But we don't." 
This is an example of the many theories and terms and ways of thinking or not thinking that is taught and asserted by psychologists, applied social psychologists, policy makers and regulation czars.  This article is worrisome to say the least.  Besure to take a minute to look it up and give it a read so that you can read the many examples of doctors and their mistaken diagnoses.  Well, that is if you have the stomach for it.

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