Signals, noise, context – and your doctor’s brain

     .    . Emergency physician, professor, author, and patient safety expert Dr. Pat Croskerry

by Carolyn Thomas      @HeartSisters 

Emergency physician Dr. Pat Croskerry tells the story of the day he misdiagnosed a patient who was experiencing unstable anginachest pain caused by coronary artery disease, and often a warning sign of oncoming heart attack. But this is what he’d said before sending that patient home:

“I’m not at all worried about your chest pain. You probably overexerted yourself and strained a muscle. My suspicion that this is coming from your heart is about zero.”

In a later interview with Dr. Jerome Groopman (author of a book I love called How Doctors Think), Dr. Croskerry explained how easily that misdiagnosis happened: Continue reading “Signals, noise, context – and your doctor’s brain”

Misdiagnosis: is it what doctors think, or HOW they think?

As a heart attack survivor who was sent home from the E.R. with a misdiagnosis of indigestion despite presenting with textbook symptoms (central chest pain, nausea, sweating and pain radiating down my left arm), I’m pretty interested in the subject of why women are far more likely to be misdiagnosed in mid-heart attack compared to our male counterparts.

Dr. Pat Croskerry is pretty interested in the subject of misdiagnosis, too. He’s an Emergency Medicine physician, a patient safety expert and director of the critical thinking program at Dalhousie University Medical School in Halifax. In fact, he implemented at Dal the first undergraduate course in Canada about medical error in clinical decision-making, specifically around why and how physicians make diagnostic errors. Every year, he gives a deceptively simple critical thinking quiz to his incoming first-year med students.

So here’s your chance to practice thinking like a doctor. Try answering these yourself, but as Dr. Croskerry advises, don’t think too hard. If you were an Emergency Department physician, paramedic or first responder, he warns, you’d have only seconds to size things up and make a decision. Don’t read ahead to peek at the answers! Now, here are your questions:   Continue reading “Misdiagnosis: is it what doctors think, or HOW they think?”