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Understanding heuristics

A question that many in Kew Gardens may have is exactly how do their doctors come up with diagnoses for their medical conditions? While advances in laboratory and radiological science now offer healthcare providers a bevy of tests to help confirm or disprove a preliminary diagnosis, many may still rely on certain indicators or their own experience when making medical conclusions. Statistics seem to show that this does not always work. Information compiled by The Institute of Medicine and shared by the Mercola website shows that roughly 12 million diagnostic errors occur in America every year.

Doctors will often turn to heuristics when determining a patient’s diagnosis. These are sets of rules that providers develop based upon what they see in their practices, hear from their colleagues, or read in medical journals. While heuristics may be useful tools in helping lead a clinician to a diagnosis, it has also been recognized that they could serve to form biases that may blind a doctor to what is really going on with his or her patient. The Agency for Healthcare Research and Quality defines the four major heuristics that contribute to physician bias to be:

  •          Availability: A doctor basing a current diagnosis based solely on what he or she has seen in past cases.
  •          Anchoring: A doctor relying on his or her initial diagnosis despite clinical evidence to the contrary.
  •          Framing: Medical decision-making influenced by external cues and collateral information.
  •          Blind obedience: A doctor placing too much emphasis on so-called “expert” opinions.

Indictors that patients may spot that imply a doctor is relying solely on heuristics may be verbal cues from a physician indicating that he or she is basing a diagnosis on opinion, or that he or she believes their problems to be contrary to what confirmatory tests are suggesting. 

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