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How can heuristics lead to diagnostic errors?

Like many in Clinton, you may wonder how it is that your doctor is able to come up with a definitive diagnosis based off what may seem (to you) to be relatively little information. The answer may both surprise and alarm you. While the unique education and experience that each physician acquires during the course of their career no doubt influences their practice, a good portion of their decision making is driven by heuristics. 

What are heuristics? They are the standard practices of a profession (think of them as "rules of thumb'). Typically, heuristics are developed through practice and by the technology available to practitioners. They become the baselines on which treatment plans are built, as clinicians compare clinical indicators to what the accepted practices are for providing care. In healthcare, you may often hear heuristics referred to as "the standard of care." 

Yet while you certainly do not want your own care to deviate from that which is the standard, an overreliance on heuristics can often be problematic. Doctors may lean so heavily on them that they end up contributing to diagnostic errors. Per the Agency for Healthcare Research and Quality, strict adherence to heuristics can prompt provider to make the following errors: 

  • Allowing their opinions to be biased by recent experience
  • Relying solely on an initial diagnostic impression
  • Putting too much stock in expert opinion
  • Allowing collateral information to bias their opinion

When your signs and symptoms run contrary to what a physician may be thinking, the risk exists that the doctor may try to make what they are seeing fit their opinion. Clinical notes that indicate your doctor ignored clinical indicators when forming your diagnosis may confirm this. If this leads to an error in your diagnosis, you may have the grounds for a malpractice claim. 

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