Update that being really smart with nearly instant access to the right answer is not going to save people from making basic cognitive mistakes.
Background :
I have an extremely common health condition. There are well established treatment guidelines freely available and those guidelines have been quite consistent for several years. They say that if life gets worse, try X. Then try Y if that doesn’t help enough.
When I told my doctor that things weren’t good and outright said I knew that such information existed (as a gentle reminder), she suggested doing Z. Z had not been recommended for many years.
When Z failed, she wanted to try Y but I explicitly asked about X. She agreed it was a good idea and suggested an X-like solution.
The pharmacy got an electronic prescription for A, which is not like X at all and is administered differently than all X-like things.
Thankfully, the mistake was caught at that point by the pharmacy and I got X.
Probable mistakes :
not using a checklist or any clinical reference material
overly trusting one’s memory
Ignoring contradictory facts from the medical records /drug prescribing software
lack of a quick feedback loop for medication questions from a pharmacy (the pharmacy first reported a problem existed over 5 days before I notified the doctor)
I have the same beliefs and have had similar experiences with doctors. A simple search for literature reviews of my condition (achilles tendinitis) showed that things they were doing like prescribing anti-inflammatories weren’t effective. I suspect that they learned things once in medical school and don’t take the time to stay up to date. And also that there is an element of social reinforcement if their doctor friends are all doing the same thing.
It makes me think back to what Romeo said about reasoning ability being “good but narrow”. That it can easily just completely overlook certain dimensions. That idea has been swimming around in my head and I am feeling more and more confident that it is hugely important.
Update that being really smart with nearly instant access to the right answer is not going to save people from making basic cognitive mistakes.
Background : I have an extremely common health condition. There are well established treatment guidelines freely available and those guidelines have been quite consistent for several years. They say that if life gets worse, try X. Then try Y if that doesn’t help enough.
When I told my doctor that things weren’t good and outright said I knew that such information existed (as a gentle reminder), she suggested doing Z. Z had not been recommended for many years.
When Z failed, she wanted to try Y but I explicitly asked about X. She agreed it was a good idea and suggested an X-like solution.
The pharmacy got an electronic prescription for A, which is not like X at all and is administered differently than all X-like things.
Thankfully, the mistake was caught at that point by the pharmacy and I got X.
Probable mistakes :
not using a checklist or any clinical reference material
overly trusting one’s memory
Ignoring contradictory facts from the medical records /drug prescribing software
lack of a quick feedback loop for medication questions from a pharmacy (the pharmacy first reported a problem existed over 5 days before I notified the doctor)
I have the same beliefs and have had similar experiences with doctors. A simple search for literature reviews of my condition (achilles tendinitis) showed that things they were doing like prescribing anti-inflammatories weren’t effective. I suspect that they learned things once in medical school and don’t take the time to stay up to date. And also that there is an element of social reinforcement if their doctor friends are all doing the same thing.
It makes me think back to what Romeo said about reasoning ability being “good but narrow”. That it can easily just completely overlook certain dimensions. That idea has been swimming around in my head and I am feeling more and more confident that it is hugely important.