Lack of time, knowledge or just sloppy thinking?

Peggy Zuckerman peggyzuckerman at GMAIL.COM
Wed May 1 19:25:04 UTC 2013


The reality is that our various strengths and weaknesses have led us to be
the biologically advance and DIVERSE kinds of creatures that we are.  With
that diversity comes the obvious physical differences, but also includes
diverse ways of processing information.  One can call that "types of
intelligences", with some people having greater spatial skills, others
greater mathematical processing or insight, others more skilled at learning
foreign languages, and so on.

The great weakness in this codified system is that the practitioners often
have the same type of thinking--it does require a lot of similar skills to
get through medical school vs art school--and that can become a
self-limiting approach in making a diagnosis.  In the case of a difficult
diagnosis, we can all certainly bring a cognitive skill to this by asking,
"What am I missing here?" or "How else can I approach this problem?".  That
is essentially asking for a reset to "start" at a time at which there seems
a need for a decisive action.  The decisive action could also be that
return to the basics, to start again, while acknowledging one's own
tendencies and style of thinking.

Peggy Z


On Wed, May 1, 2013 at 11:34 AM, Lorri Zipperer <Lorri at zpm1.com> wrote:

> *From:* pb [mailto:mikburger22 at yahoo.com]
> *Sent:* Wednesday, May 01, 2013 12:27 PM
> *To:* Society to Improve Diagnosis in Medicine; Lee Tilson
> *Subject:* Re: Lack of time, knowledge or just sloppy thinking?****
>
> ** **
>
>  ****
>
> I agree our strengths play into our weaknesses.****
>
>  ****
>
> And it is difficult to easily catch the problems which arise from this.***
> *
>
>  ****
>
> However, Ive tried.   I teach medical students and much of the time is ***
> *
>
> focused on how to avoid cognitive error.  This involves analysis of ****
>
> what type of errors we are prone to making, e.g. hyper focusing or ****
>
> being easily distracted, making fundamental errors in logic or ****
>
> creating tight logical analysis but overlooking the weak premise.    ****
>
>  ****
>
> I also try to incorporate the contributions of those who utilize non
> linear "thinking" approaches to clinical problem solving and the care of
> patients.   (The way our hospitals****
>
> are structured, with the resultant high incidence of nosocomial infection,
> falls, ****
>
> privacy invasion, etc. and phenomenal cost a good example of ignoring
> those who excel****
>
> at what is considered "non medical thinking").            ****
>
>  ****
>
> Perhaps medicine is about to enter a new era where better understanding of
> ****
>
> cogntive processing and the wide spectrum of unique and useful abilities *
> ***
>
> not currently being tapped will be brought into practice.****
>
>  ****
>
> Pogo has been right - ****
>
>  ****
>
> Paul****
>
>  ****
>
>  --- On *Wed, 5/1/13, Lee Tilson <lee.tilson at GMAIL.COM>* wrote:****
>
>
> From: Lee Tilson <lee.tilson at GMAIL.COM>
> Subject: Re: Lack of time, knowledge or just sloppy thinking?
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Date: Wednesday, May 1, 2013, 12:26 PM****
>
> I am a newbie here. However, there are some verbal patterns that can be
> recognized as well.  ****
>
> ** **
>
> Indeed, there are many aspects of these human tendencies, I was trying to
> focus on this point.  ****
>
> ** **
>
> Our human tendencies   =   Our strengths   =    Our weaknesses****
>
> ** **
>
> The idea that we can make a prescription that will eliminate error or bad
> reasoning seems incorrect to me. ****
>
> ** **
>
> ** **
>
> ** **
>
> Lee Tilson****
>
> ** **
>
> ** **
>
> n Wed, May 1, 2013 at 1:07 PM, pb <mikburger22 at yahoo.com<http://us.mc1200.mail.yahoo.com/mc/compose?to=mikburger22@yahoo.com>>
> wrote:****
>
>   ****
>
> *"Example: The human tendency of "ignoring details" is essential in order
> to recognize new patterns in the world."*****
>
>  ****
>
> This gets into the area of non verbal intelligence and pattern recogntion.
> *   *****
>
>  ****
>
> http://www.foundalis.com/res/bps/bpidx.htm****
>
>  ****
>
> The British try to test their medical school applicants for this ability**
> **
>
> through a subsection of the UKCAT where applicants have to evaluate shapes
> in****
>
> two different groups, determining the relevant nature of the visual
> relationships ****
>
> in each group and how the two groups then differ. ****
>
>  ****
>
> Paul****
>
>  ****
>
>  ****
>
>  --- On *Wed, 5/1/13, Lee Tilson <lee.tilson at GMAIL.COM<http://us.mc1200.mail.yahoo.com/mc/compose?to=lee.tilson@GMAIL.COM>
> >* wrote:****
>
>
> From: Lee Tilson <lee.tilson at GMAIL.COM<http://us.mc1200.mail.yahoo.com/mc/compose?to=lee.tilson@GMAIL.COM>>
> ****
>
>
> Subject: Re: Lack of time, knowledge or just sloppy thinking?
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<http://us.mc1200.mail.yahoo.com/mc/compose?to=IMPROVEDX@LIST.IMPROVEDIAGNOSIS.ORG>
> ****
>
> Date: Wednesday, May 1, 2013, 11:01 AM****
>
> The same human tendencies that are strengths are weaknesses.  The same
> human tendencies that enable progress also account for mistakes. ****
>
> ** **
>
> If this was not true, then Darwinian evolution would have eliminated those
> tendencies. ****
>
> ** **
>
> ** **
>
>  It also leads to a lot of mistakes. ****
>
> ** **
>
> Is "ignoring details" good or bad? I think it is both, depending on how it
> is being used. ****
>
> ** **
>
> In order to recognize new patterns of facts in the world, new categories
> of physical processes, new abstract entities, new kinds of diseases, new
> kinds of mechanisms, we have to ignore a lot of details.  Our ability to
> generate new categories (e.g. physicians look at patterns of patients and
> invent new disease concepts)  that we use for analyzing circumstances is
> essential to medicine. ****
>
> ** **
>
> How do we generate new categories? To generate a new category requires
> that we focus on essential similarities and ignore non-essential details.
> We look at a group of similar patients and see patterns. Details that do
> not fit the pattern have to be ignored. ****
>
> ** **
>
> Our ability to focus on similarities and ignore some details enables the
> creation of new disease concepts. We cannot make progress in medicine
> without training ourselves to ignore some details.  ****
>
> ** **
>
> This same ability to focus on essential similarities and to ignore some
> details can cause mistakes. ****
>
> ** **
>
> My favorite philosopher says that the most interesting thing about logical
> fallacies is not that they are wrong, but that they are seductive.
> Understanding why and how we are seduced into error is very complicated. *
> ***
>
> ** **
>
> Or, as Walt Kelly used to say in Pogo, "We have met the enemy and he is
> us."****
>
> ** **
>
> Lee Tilson****
> ------------------------------
>
> ** **
>
> ------------------------------
>
>
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> Moderator: Lorri Zipperer Lorri at ZPM1.com, Communication co-chair, Society
> for Improving Diagnosis in Medicine
>
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> Save the date: Diagnostic Error in Medicine 2013. September 22-25, 2013 in
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> http://www.dem2013.org




-- 
Peggy Zuckerman
www.peggyRCC.wordpress.com







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