I think and feel I have a lot to say about how detrimentally medicine is practiced in our fast-paced business of ours these days. I've seen it in my own career and in many other colleagues' careers too. In this commentary, I'm going to do something I've never done before or at least didn’t think about it on a deeper level. I'm going to pull back the curtain, and, I'm going to show you where we have erred and continue to do so in our daily practices. More specifically, what we have become--Robotic box checkers-- as modern-day clinicians.
Moreover, why what we or you're doing isn't working as well as you'd like to admit, and what to do instead? I'll show you not one, but 2 root causes where we have unconsciously abdicated our very own thinking selves. As medicine pushes for profits, we too have been pushed to become super “fast thinkers” when providing medical services to the patient community. In many respects, we have become too automated, even protocolized in many instances. Do not misunderstand me, I am not against abiding by following practice or clinical guidelines, or even abiding by organizational protocols. Obviously, they have a role in standardizing medical care. However, be that as it may, be, I feel, we have relinquished our clinical thinking to a robotic mode, or simply to the activity of “checking boxes” in our minds. Luckily, Psychologists have looked into this phenomenon.
Interestingly enough, Cognitive Psychology proves this very clearly. This is when we all practice Medical Heuristics (aka, rules of thumb applied as they say it). Unfortunately, this mindset–although very convenient–oftentimes leads us astray in our medical decision-making activities. Sadly and tragically, this leads us to medically misdiagnose, or delay the appropriate treatment, therefore the increasing plethora of potential medical errors and adverse outcomes we see occurring across the continuum of medical care. See, this is where we are all doing it all WRONG! Not slowing down to pause & think and look beyond the immediacy or even look at the big picture when making clinical decisions in our daily busy practices. In essence and sadly that has become our Achilles heel in many legal instances.
I know to some that statement might come across as a bit sanctimonious. But know this, and rest assured I know this firsthand & better than most. Why? Because I have seen this issue occur over and over. Furthermore, from a different lens than yours: that of a medical-legal consultant perspective. Mostly when I have served as an expert reviewer in alleged PA med-mal claims, but sadly…there it is--the elephant in the middle of the room. Perhaps we should start being more open about this problem.
However, in the spirit of sharing, I just had to remind you of this. And from a Risk Management perspective, I'm telling you, that knowing this body of knowledge helps mitigate your clinical risks. In other words, this stuff works if you familiarize yourself with these inherent biases (Medical Heuristics) and understand how to consciously sidestep them in your everyday patient encounters, whether it is in the office, ED or urgent care settings, or hospital. At the very least, it's worth taking a few minutes more of your time to see for yourself what I'm talking about when you put these techniques into practice. It will give you a better understanding of the legal landmines lurking in the background.
Start practicing safely and confidently...don’t take chances by being or becoming an automated provider. Better yet, don't sabotage your own career. Stay present, become an engaged provider, and allow your fast (unconscious) and slow thinking (conscious) to coexist harmoniously when making your final clinical decisions. Your patients will be less inclined to raise any potential medical malpractice claims knowing that you balanced your options before making a rash decision. You owe it to them...you owe it to yourself.
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