quick ?

Sun Apr 27 23:19:42 UTC 2014

Let me open a new front in this discussion
one driven by my training and interest in Theory of Constraints (cf Goldratt).
Diagnostic Errors are UDEs (Undesirable Effects) .
I think we understand The Goal here, but don't have a crisp statement of it
nor a good measure of our approach toward it. But we really need to construct
a Current Reality Tree (CRT) and drive it back to finding the Core Problem,
which we can then seek to change and perhaps decide what to change it to
before we focus on How to Make the Change, perhaps using an Evaporating Cloud (EC).
This kind of analysis might advance the field substantially but would require time
and perhaps several Jonah-like protagonists. 
If one of this listserve's other readers has such ToC training or interest, I would be happy
to contribute to the process.
Just a thought.
Stephen G. Pauker, MD, MACP, FACC, ABMH, AGI Jonah
Professor of Medicine and Psychiatry
Please note new email address;
spauker at tuftsmedicalcenter.org


From: John Brush [mailto:jebrush at ME.COM]
Sent: Sun 4/27/2014 1:40 PM
Subject: Re: [IMPROVEDX] quick ?

I have been following this conversation and I continue to believe that our best way to improve diagnosis in medicine is to teach good habits. Teach people to be systematic, to appropriately use the available tools, and to calibrate their intuitive approaches with better numerical literacy and probability estimates.  Focusing on errors doesn't seem like a very fruitful path forward. 

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