Ten Commandments to Reduce Diagnostic Errors

Nonie Leonidas nonieleonidas68 at GMAIL.COM
Tue Aug 26 01:08:39 UTC 2014


Hi Lorri,

I an not sure if I have sent this to the Listserve before. This is another
set of 10 C:


Ten Commandments to Reduce Cognitive Errors



   1. Thou shalt reflect on how you think and decide.
   2. Thou shalt not rely on your memory when making critical decisions.
   3. Thou shalt make your working environment information-friendly by
   using the latest wireless technology such as the Tablet PC and PDA.
   4. Thou shalt consider other possibilities even though you are sure of
   your first diagnosis.
   5. Thou shalt know Bayesian probability and the epidemiology of the
   diseases in your differential diagnosis.
   6. Thou shalt mentally rehearse common and serious conditions that you
   expect to see in your specialty.
   7. Thou shalt ask yourself if you are the right person to make the final
   decision or a specialist after considering the patient’s values and wishes.
   8. Thou shalt take time to decide and not be pressured by anyone.
   9. Thou shalt create accountability procedures and follow up for
   decisions made.
   10. Thou shalt record in a relational data base software your patient’s
   problems and decisions for review and improvement.


Copyright Leo Leonidas 2003


On Sun, Aug 24, 2014 at 9:13 PM, Lorri Zipperer <Lorri at zpm1.com> wrote:

> Forwarded by the moderator:
>
>
>
> From Dr. Leonardo Leonidas, Bangor, Maine 20 May 2001  Copyright 2001
>
> Given to his Son Len and Class 2001 Tufts University School of Medicine
>
>
>
>    1. Thou shalt First "Do No Harm."
>
>    2. Thou shalt think of serious and treatable conditions and act on them
> without delay.
>
>    3. Thou shalt remember that Diagnosis is History, History, History.
> Then confirm with clinical examination and more History.
>
>    4. Thou shalt request a test only if it will change your plan or help
> in predicting the outcome.
>
>    5. Thou shalt question "authority" such as your senior residents,
> attendings, experts, or even National guidelines.
>
>    6.  Thou shalt continue the debate and questioning even though the data
> is "IN."
>
>    7. Thou shalt maintain a high index of suspicion for uncommon
> presentations of the common.
>
>    8. Thou shalt recognize your own beliefs, biases, prejudices, and
> thinking style.
>
>    9. Thou shalt be wary of your hunches and intuitions. It is better to
> use Evidence Based Medicine.
>
>   10.  Thou shalt have an iPad* or a smartphone in your palm.
>
>
>
> *Palm Pilot in the first edition.
>
>
>
> Leonardo L. Leonidas, MD
>
> Assistant Clinical Professor in Pediatrics (retired 2008)
>
> Tufts University School of Medicine, Boston, USA
>
> nonieleonidas68 at gmail.com <mailto:nonieleonidas68 at gmail.com
> <nonieleonidas68 at gmail.com>>
>
>
>
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