Tag: unwarranted clinical certainty

Do Emergency physicians diagnose? Or not?

~ Carolyn Thomas ~ 10 Comments

by Carolyn Thomas  ♥  @HeartSisters 

Australian researcher Dr. Mary Dahm and I were emailing back and forth about her recently published study on diagnostic uncertainty in medicine (one of my favourite subjects, I might add – especially when it involves female heart patients).  I mentioned to her that the Emergency physician who had misdiagnosed my heart attack as acid reflux seemed remarkably confident at the time – despite being remarkably wrong. That misplaced confidence is what researchers who study diagnostic error call unwarranted certainty – a contributing risk factor for misdiagnosis.  But Dr. Dahm raised the issue of whether diagnosing is what Emergency physicians actually do:

“The question about whether or not Emergency Department doctors diagnose is highly contested within the specialty. Regardless, they do exclude life-and limb-threatening conditions.”          .
 Continue reading “Do Emergency physicians diagnose? Or not?” →

Diagnostic Uncertainty vs. Unwarranted Certainty: which is worse for patients?

~ Carolyn Thomas ~ 19 Comments

by Carolyn Thomas     ♥    @HeartSisters 

The Emergency physician who misdiagnosed my heart attack displayed not even a whiff of uncertainty while delivering that misdiagnosis.  “YOU” – he declared confidently – “are in the right demographic for acid reflux!”  (without any gastrointestinal diagnostic tests). He sent me home that day with instructions to ask my family doctor to prescribe antacid drugs for my symptoms (central chest pain, nausea, sweating and pain down my left arm).  I now suspect that, if only that confident doc would have bothered to Google my symptoms, both he and Dr. Google would have landed on the same search result:  myocardial infarction (heart attack).

But in fact, he seemed remarkably certain despite being remarkably wrong.   . Continue reading “Diagnostic Uncertainty vs. Unwarranted Certainty: which is worse for patients?” →

Misdiagnosis: the perils of “unwarranted certainty”

~ Carolyn Thomas ~ 9 Comments

by Carolyn Thomas  ♥  @HeartSisters

Until being misdiagnosed with indigestion in mid-heart attack, I generally trusted that all people with the letters M.D. after their names knew what they were talking about when diagnosing serious medical problems. That was long before I tracked down a study(1) reported in the New England Journal of Medicine that women under the age of 55 who are experiencing a heart attack are seven times more likely to be misdiagnosed and sent home from the E.R. compared to their male counterparts presenting with identical symptoms.

And that’s why I now find Dr. Jerome Groopman’s landmark book, How Doctors Think, so illuminating.  It should be required reading for all med school students.  Continue reading “Misdiagnosis: the perils of “unwarranted certainty”” →