"Rush to treatment"

Bob Swerlick rswerli at GMAIL.COM
Wed Nov 30 20:13:28 UTC 2016


Excellent and insightful point. When incentives are linked to doing things
fast and there are no metrics as to whether they were the right actions in
the first place, you will gets lots of speed and little judgment.

Bob Swerlick

On Wed, Nov 30, 2016 at 12:58 PM, Hess, Dr. Donald <
dhess at susquehannahealth.org> wrote:

> Greetings:
>
>
>
> Patients presenting to the ED with acute STEMI, CVA or sepsis are managed
> according to standardized, time-sensitive, treatment protocols. I wonder to
> what extent the “rush-to-treatment” contributes to the diagnostic
> discordance seen between admission & discharge. These protocols ensure that
> making the diagnosis becomes secondary to determining whether or not the
> patient meets inclusion criteria for treatment. It’s easier to treat now
> and diagnose later. I recall that this is a cognitive strategy mentioned in
> Kahneman’s Thinking, Fast & Slow. If a question is too difficult to answer
> (making the best diagnosis given the available information), then simply
> transform it into a question that is easier to answer (does this patient
> meet inclusion criteria for treatment?)
>
>
>
> I realize that these emergent situations are fraught with uncertainty and
> that often the risks are unknown. Nevertheless, I suspect that the
> rush-to-treatment also precludes a meaningful discussion with the patient &
> family regarding risks, benefits, alternatives, uncertainties, & possible
> outcomes.
>
>
>
> Regards, Don
>
>
>
> *DONALD W. HESS, MD, MPH*
> *Director, Continuing Medical Education*
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-- 
Bob Swerlick






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


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