FW: Cognitive Biases and the Human Brain - The Atlantic

Michael Grossman Michael.Grossman at MIHS.ORG
Mon Aug 6 16:29:41 UTC 2018


True observations that are disquieting



Sent with Good (www.good.com)


 -----Original Message-----
From: 	Bruno, Michael [mailto:mbruno at PENNSTATEHEALTH.PSU.EDU]
Sent:	Monday, August 06, 2018 07:42 AM US Mountain Standard Time
To:	IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject:	Re: [IMPROVEDX] FW: Cognitive Biases and the Human Brain - The Atlantic

Very insightful of Upton Sinclair, and of you too, Dr. Swerlick!  

 

We’ve created healthcare systems that do exactly what they were designed to do: maximize revenue.  And they do it quite well, and despite a challenging economic environment in healthcare.  The tradeoff for this very tangible benefit is high levels of physician burnout, a poor patient experience, and sub-optimal quality and safety in patient care.  If we want our healthcare systems to do other things instead, such as provide excellent healthcare to patients, or if we perhaps want our systems to become the kind of working environment that does not produce physician burnout on a massive scale, then we will need to fundamentally redesign them. 

 

It is the same reasoning that has been applied to the electronic medical record (see the attached article).

 

All the best,

 



Michael A. Bruno, M.S., M.D., F.A.C.R.   
Professor of Radiology & Medicine

Vice Chair for Quality & Patient Safety

Chief, Division of Emergency Radiology

Penn State Milton S. Hershey Medical Center
( (717) 531-8703  |  6 (717) 531-5737

* mbruno at pennstatehealth.psu.edu <mailto:mbruno at pennstatehealth.psu.edu>   |  
 

 

*****E-Mail Confidentiality Notice*****
This message (including any attachments) contains information intended for a specific individual(s) and purpose that may be privileged, confidential or otherwise protected from disclosure pursuant to applicable law.  Any inappropriate use, distribution or copying of the message is strictly prohibited and may subject you to criminal or civil penalty.  If you have received this transmission in error, please reply to the sender indicating this error and delete the transmission from your system immediately.

 

 

From: Swerlick, Robert A [mailto:rswerli at EMORY.EDU] 
Sent: Sunday, August 05, 2018 3:44 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] FW: Cognitive Biases and the Human Brain - The Atlantic

 

The skepticism regarding de-biasing is not a ther it works or doesn't. It may work in specific circumstances with specific populations. In healthcare delivery, the question is where are those circumstances where training people results is meaningful return on investment and where are the circumstances where the environment (system issues) are so overwhelming that it does not make sense to try to de-bias those who embedded in such systems. 

 

The environments I observe are volume driven and financially reward heavy dependence on system one engagement. De-biasing will almost certainly require engagement of system 2 translating to less volume less volume and fewer $'s. Unless there are meaningful changes in how we reward practice activities, this will be a hard sell. I can't help but recall a quote from Upton SInclair:

 

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” 
― Upton Sinclair <https://www.goodreads.com/author/show/23510.Upton_Sinclair> , I, Candidate for Governor: And How I Got Licked <https://www.goodreads.com/work/quotes/254630> 

 

Robert A. Swerlick, MD

Alicia Leizman Stonecipher Chair of Dermatology

Professor and Chairman, Department of Dermatology

Emory University School of Medicine

404-727-3669 

 

 

________________________________

From: Pat Croskerry <croskerry at EASTLINK.CA>
Sent: Sunday, August 5, 2018 11:50:39 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] FW: Cognitive Biases and the Human Brain - The Atlantic 

 

Thanks for the link.

 

Evidence that the pessimism about bias mitigation is unwarranted is accumulating. Nobody said it would be easy, but nobody should say it can’t be done. 

 

Nisbett’s work is acknowledged in this piece – his recent book describes a number of strategies: Mindware: Tools for Smart Thinking . 

Further, a recent review in Medical Decision Making found that most of 74 interventions in 13 studies were effective: 

(Ludolph R, Schulz PJ. Debiasing health-relas and decision making: A systematic review. Medical Decision Making 2017; 38 3–13).

 

  

 

From: mgraber <graber.mark at GMAIL.COM> 
Sent: August 5, 2018 11:25 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] FW: Cognitive Biases and the Human Brain - The Atlantic

 

Thanks to Eta Berner for this …..

 

https://www.theatlantic.com/magazine/archive/2018/09/cognitive-bias/565775/

 

 

 


________________________________


Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 

or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX


Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/


To unsubscribe from the IMPROVEDX:
mail to:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
or click the following link: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG

For additional information and subscription commands, visit:
http://www.lsoft.com/resources/faq.asp#4A

http://LIST.IMPROVEDIAGNOSIS.ORG/ (with your password)

Visit the searchable archives or adjust your subscription at:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX

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

To unsubscribe from the IMPROVEDX list, click the following link:<br>
<a href="http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1" target="_blank">http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1</a>
</p>


More information about the Test mailing list