Another look at Questions

robert bell rmsbell200 at YAHOO.COM
Sat Jan 2 22:51:44 UTC 2016

Dear All,

I would like to thank all the people on this list who kindly responded to my questions a few weeks back.

Since asking those questions I became aware that questions may be creative.

Does it follow then that statements are less creative. I then thought how does that come about? 

A question I thought, stimulates listeners and readers to think of various solutions. So from one question you might get many solutions. With statements you would be more relying on the creativity of the writer presenting his or her various ideas and solutions. And these all together may not be great in number. 

With regard to the medical profession as a whole and people in positions of power in the healthcare industry who can effect change, one can ask do they ask fewer questions for fear of being considered less knowledgeable? So, if this is true, almost by definition, if questions are creative, such decision makers are less likely to be broadly creative, at least initially? There are obvious exceptions. So a  question might be how to better take advantage of the crowd think? 

This all makes an assumption that most things in medicine are complex and that many solutions to an issue may be necessary to arrive at a good solution.

The IOM has issued its statement/report on diagnostic errors and there are some good suggestions. I was pleased to see teamwork mentioned first in their solution. Which essentially is an extension of crowd think.

But the big question is where do we go from here? As you all know I would have preferred standard medical errors to be approached first before diagnostic errors. For example, I felt that if there is a significant error rate in radiology reports and laboratory tests that this should be addressed first. But assuming that we may have the cart before the horse, and I am not completely sure about that, what questions could be asked of the established consortium of speciality societies?

Over and above the big structural solutions, what comes to mind for me is that some of these societies have issued Do and Don’t lists for their members.

So my new question is, could those lists be looked at and the idea extended to all the specialty societies with the emphasis on reducing diagnostic error?

Also, with any statement(s) would it be good to consider asking some questions at the end to stimulate thought?

The best for 2016,

Robert M. Bell, M.D., Ph.C.

Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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