How Doctors Think: Two Heads Are Better Than One

My husband came home yesterday with a story about an employee who was misdiagnosed with a back problem. Gary is a tall, once 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, 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.

Knowing the work I do, Gary shared this experience with my husband, calling it 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.

We all 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.

Stranger Than Fiction: Hospital Safety by the Numbers

Did you know that one in three patients is accidentally harmed during a hospital stay? That adds up to about 13 million patients a year who suffer needlessly, and among those, about 400,000 people die as a result in a given year.

When we talk about these big numbers, it’s really hard to wrap our heads around what they mean in real-life terms. So imagine this:

You wake up tomorrow morning to the news that three, fully loaded passenger jets crashed overnight in an Iowa cornfield. There were no survivors.

The media floods Iowa to cover the triple tragedy. The entire world demands answers. What went wrong? Who’s to blame? Grief permeates the air. Hearts go out to the victims and their loved ones. That night, sleep is elusive.

The next morning, headlines shriek again: Three more planes down in the dark night; all passengers and crew are dead. Every imaginable government agency and corporation rush to stem panic and find solutions.

But the third day dawns with numbing news that three more planes full of innocent passengers who dared to board those planes had disintegrated overnight. It feels like the world is coming to an end. However, it’s clear this string of deadly disasters has finally stopped — the airline industry has gone down in flames too. No one even thinks about stepping foot on a plane.

Nine planes crashed. 2,457 innocent people lost their lives on big-name carriers they trusted. But guess what…

During the same three days, 3,000 patients accidentally died in hospitals they trusted. Except the accidental deaths in U.S. hospitals didn’t stop at day three. In fact, they never stop. And the media… they say it’s an old story so barely give notice. And besides, when we’re sick, we have to go to a hospital. What’s the alternative?

Airline travel is 3,000 times safer than hospital care. The airline industry has been pretty open about its safety records, but it wasn’t until recently that we had any guides for choosing safe hospitals. But now we do. Before you or a loved one ever needs hospital care, be sure to check out your options here:

Pilots never take off without a co-pilot and they always go through their safety checklists together. You should never go to a hospital without a friend or family member as your Care Partner. And both of you should go prepared with your CampaignZERO safety checklists, too.

Hospital hazards for patients are mostly invisible to the naked eye. But when you have your hospital checklists, you’ll know what to look for, what to do, and what to say to get safe and sound care for the people you love.

Patients Forget Most of What Their Doctors Say — But There’s an App for That!

When we’re under the weather, our minds and memories simply don’t operate at 100%. Fortunately, we have smart phones and smart apps to help us “fill in the blanks.” For every doctor’s appointment, ask your doctor’s permission to record your conversation so you won’t miss a detail.

Listen later, as often as you like. Just hit “Send” to share the recording with your loved ones who want to know how you are doing.

Don’t forget!

When a Medical Error is Not

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.

Defensive Medicine Isn’t Safe Medicine

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.