Medicine and logic

I have an ambivalent relationship with the medical profession. On the one hand - my left - I lost a finger because a general practitioner refused to investigate a wart, that turn cancerous. On the other, I think medicine is one of this civilisation's greatest achievements, at least when it is made available to people.

But I don't think highly of medical practice. So it comes as a great pleasure to read a medical practitioner saying:

So I was very happy to read an article in The Boston Globe today entitled, The mistakes doctors make by Dr. Jerome Groopman. Unfortunately, the online version of the article doesn’t have the informative graphic that accompanies the paper version. Dr. Groopman nicely illustrated a single case where fallacies in doctors’ reasoning led to a woman being misdiagnosed over and over again.

Why and how could this occur? Aren’t doctors taught to think logically and critically?

Well, it occurs for numerous reasons, but Dr. Groopman noted,

Physicians are rarely taught about pitfalls in cognition. During their training, they work as apprentices to senior doctors. They learn largely by doing. In today’s medical system, where there is intense pressure to see as many patients as possible, the quick judgment is often rewarded. Unfortunately, working in haste is a setup for errors in thinking.

Doctors (and therapists) don’t receive any formal education in logical fallacies. And call it laziness or human nature, but once a person has a diagnosis given by another professional (especially one given by a professional in the same specialty or degree as oneself), that tends to be the starting point for the next professional, not a blank slate.

It is for this reason that many people have diagnoses added to their record, but few removed. New professionals don’t rule out the possibility of the old diagnosis, they just add another one to capture what they believe is going on with the individual.

I would be more than happy to run a critical thinking course for medicos. Just say the word.