Gary is a tall, lanky 50-something guy whose stooped posture now betrays pain and significant muscle deterioration. He has the walk and energy level of a 90-year old and, despite weekly therapy prescribed by an orthopedic specialist, his body seemed to be aging by the minute.
Fortunately for Gary, his wife spoke up to her neurologist at one of her own recent appointments and described his condition. Amazingly, the neurologist offered a diagnosis on the spot that turned out to be ‘spot on’! Gary switched doctors and has every reason to hope for full recovery of his old athletic self.
Gary shared this experience with my husband, calling his first doctor’s failure diagnose his back pain correctly a “medical error”. A year or so ago I would have agreed, but I think differently now that I’ve read a terrific book by Jerome Groopman, How Doctors Think. Groopman describes how doctors form their professional judgments – exactly how all of us form our ideas about things.
All of us have life experiences that shape how we perceive and analyze information. Whether we realize it or not, we are chock full of filters – some would call them biases. For the most part, they tend to serve us well. How else could we sort through the information overload we seem to manage on a daily basis?
Doctors tend to filter patients’ information in the same way. They hear or see a set of symptoms and their minds immediately sort through past history with the same symptoms to come up with a solution or cure.
In Gary’s case, he saw an orthopedic doctor who saw his symptoms through the prism of his own experience with the bones and muscle of the back. His wife’s neurologist analyzed the same set of symptoms through the prism of his specialty – the nervous system that runs through the back. I don’t believe the first doctor made a mistake – he just did not have exactly the right filter for Gary’s problem.
So what’s the moral of this story? Trust yourself, trust your body. If you’re not getting better under one doctor’s care, get another doctor’s brain on your case. Get a third or fourth opinion if necessary. Don’t stop until it feels like you have the right doctor for you with the right solution you need.
Recently, Gallup published the results of a study showing that a whopping 26% of our healthcare costs cover “defensive medicine.”
If you’re not familiar with this term, think about the times your doctor has ordered a test for you that seems a little on the “iffy” side – you’re not quite sure what the test is for, or you’ve been through it before, and it seems like a big waste of time to you. But you dutifully follow doctor’s orders because, after all, insurance is paying for it anyway.
On the other hand, maybe you’ve insisted on a test that gave your doctor cause for pause. You didn’t want to go to the effort of getting a second opinion so you insisted – and your doctor relented, and then off you went… for a CAT scan, MRI, stress test, or blood work.
In these scenarios, the undercurrent driving tests and procedures is fear – fear in your doctor’s heart that if any possible stone is left unturned, you, dear patient, will see your doctor in court.
You must be wondering why this concerns us at CampaignZERO. What does defensive medicine have to do with patient safety?
Here’s our take on the connection —
- When doctors feel defensive, they don’t have the luxury to feel introspective too. It’s a common-sense fact — the two emotions simply don’t coexist peacefully in a single caring soul.
- If doctors can’t be introspective, they can’t get to “sorry” when they make an error (as all humans do sometimes – despite very best efforts and intentions.)
- If doctors can’t get to sorry, they can’t learn from their mistakes. They can’t become better doctors and better human beings.
So, while money and cost should be a concern for all of us, we should care just as much about the caretaker — who will then do a better job of taking care of us.
Let’s break the vicious circle of defensive medicine. Let’s start building a caring circle of better, safer medicine.