Cok Kinzler PLLP

Connecting heuristics to diagnostic errors

The doctors staffing the hospitals and clinics throughout Bozeman put a great deal of time and effort into their education and training. The expectation that comes from that is that they will be able to recognize the appropriate clinical indicators when diagnosing and subsequently treating patients. Diagnostic errors, however, remain a huge problem in healthcare. According to study information shared by the National Patient Safety Foundation, as many as 80,000 people per year may die due to diagnostic errors. This alarmingly high incidence rate may cause many to question how, with all of the technology at their disposal, are doctors able to assign a wrong diagnosis. 

Protocols exist in nearly every profession, with healthcare being no exception. Clinicians refer to them specifically as heuristics. Such protocols often define a patient's course of care. While heuristics may be useful in helping to guide a doctor in providing care, they also present the potential for danger in that clinicians may rely too heavily on them. The Agency for Healthcare Research and Quality lists four types of heuristics that have been identified as contributing to diagnostic errors: 

  • Availability: Diagnoses that are biased based on a clinician's experience with past cases
  • Anchoring: Diagnoses that are too heavily influenced by an initial diagnostic impression
  • Framing: Diagnoses that are biased due to collateral information and external cues
  • Blind: Diagnoses that are based largely off of expert opinion

The problem in each of these scenarios is that doctors may allow their opinions on a patient's condition to be swayed by something other than clinical indicators. Anytime a physician ignores diagnostic test results that conflict with his or her impressions, the potential for trouble is present. This can often be seen in documentation, when a doctor indicates his or her decisions are based more off opinions rather than results. 

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