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Are doctors omniscient?

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The New Yorker issue of 2007-01-29

Posted 2007-01-22

What's the trouble? How doctors think.

by Jerome Groopman

.... Medical education has not changed substantially since Pat

Croskerry and I were trained. Students are still expected to

assimilate large amounts of basic science and apply that knowledge as

they are taught practical aspects of patient care. And young

physicians still learn largely by observing more senior members of

their field. ( " See one, do one, teach one " remains a guiding maxim at

medical schools.) This approach produces confident and able

physicians. Yet the ideal it implies, of the doctor as a

dispassionate and rational actor, is misguided. As Tversky and

Kahneman and other cognitive psychologists have shown, when people

are confronted with uncertainty -- the situation of every doctor

attempting to diagnose [or to treat] a patient -- they are susceptible to

unconscious emotions and personal biases, and are more likely to make

cognitive errors. Croskerry believes that the first step toward

incorporating an awareness of heuristics and their liabilities into

medical practice is to recognize that how doctors think can affect

their success as much as how much they know, or how much experience

they have. " Currently, in medical training, we fail to recognize the

importance of critical thinking and critical reasoning, " Croskerry

told me. " The implicit assumption in medicine is that we know how to

think. But we don’t. "

http://www.newyorker.com/fact/content/articles/070129fa_fact_groopman

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