Cognitive error - It applies to treatment too

Nonie Leonidas nonieleonidas68 at GMAIL.COM
Mon Dec 1 07:55:47 UTC 2014

My other 10 Commandments:

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 iPad, Kindle, Samsung
   Notes, Nexus.
   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

Leonardo L. Leonidas, MD

Assistant Clinical Professor in Pediatrics (retired 2008)

Distinguished Career Teaching Award, 2009

Tufts University School of Medicine, Boston, USA

Now in the Philippines giving talks and blogging on Reducing Medical Errors.

On Sun, Nov 30, 2014 at 2:16 PM, Mark Graber <
mark.graber at> wrote:

> A Boston Globe article
> <> recently
> called attention to an error made during a surgical procedure, and its
> cognitive underpinnings.  We’ve spent a lot of time considering how
> cognition contributes to diagnostic errors, but this article show how these
> same tendencies can play out in treatment and management;  Nice to know we
> don’t hold the exclusive rights to make these mistakes !   Seems like even
> more of a reason to include something in the medical curriculum on
> cognitive psychology.
> The article includes an interesting comment from Pat Croskerry.
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