Biases of a different kind. A way Forward?

Applegate, Kimberly E keapple at UKY.EDU
Tue Feb 26 18:37:13 UTC 2019


Might we start with explicit patient advocate involvement in all aspects of healthcare and health policy? Our conversations do change when the patient is in the room. Perhaps our learning and decision-making might as well.

Kimberly Applegate, MD, MS

Professor of Radiology and Pediatrics


________________________________
From: Tom Benzoni <benzonit at GMAIL.COM>
Sent: Tuesday, February 26, 2019 12:54 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Biases of a different kind. A way Forward?

Re-solving this entails doing something inherently tough:
Invite in people who are different than us.
There is a tendency to surround ourselves with mirrors; this tactic promotes safety and predictability.
The question is: do you want he same predictable outcomes?
If so, continue doing the same thing; if not, then do something, anything, different.

Now comes the hard part.

Because of blind-spot bias, we think everyone else has to change but I'm OK.
If this makes sense, then what can this group do to start this change?

tom benzoni

On Mon, Feb 25, 2019 at 11:20 PM Robert Bell <0000000296e45ec4-dmarc-request at list.improvediagnosis.org<mailto:0000000296e45ec4-dmarc-request at list.improvediagnosis.org>> wrote:
Dear all,

I have been on line with this and one other organization dedicated to errors in medicine.

I could be wrong but there seems to be no major advances in terms of the estimated rising numbers of patients still experiencing error.

There are the small things all over that one would guess would save a few lives, and occasionally a big study that saves many lives globally, e.g. Dr. Pronovost’s catheter study. But not too many.

Why is this?

I would argue that it is mainly due to biases, yes biases, but not the ones we often talk about.

We all have ideological biases that in most come from the persons walk through life and upbringing.

But then there are the loyalty biases that often come from where one's money/salary comes from, and maybe from an organization of which one is a member.

One notices the absence of comment on this list from time to time about certain topics.

These biases, I believe, inhibit many from speaking up and suggesting new creative ideas that could be breakthroughs in medicine if adopted.

I do not have a magic wand on how to break through all the barriers, but have noticed a few things.


  *   It seems that retired persons are more free to speak out than others.
  *
  *   Women, seem to speak out more often.
  *
  *   And Think Tanks which employ their own experts frequently speak out.
  *
  *   And finally we must not forget imaginative leadership - some people have immense abilities to make a difference by fostering collaboration, getting things done, and saving lives.

So with all these, how to break through the obstacles, and in error terms, have the equivalent of putting a women or a man on the moon, or having a cure for HIV/AIDS in 10 years, that in turn leads to dramatic reductions in deaths and injuries due to error!

Would welcome thoughts.

Rob Bell, M.D.



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