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Doctors' mental biases can lead to misdiagnosis

One of the most common forms of medical malpractice is misdiagnosis. One insurance company reviewed 2,000 claims recently and discovered that misdiagnosis was a principal factor in 313 of the cases. Maryland residents may be interested to learn that misdiagnosis was the second most expensive form of malpractice and the third most common in the cases surveyed.

There has been a movement recently among medical professionals to identify the causes of misdiagnosis. Some of the known causes are system failures, such as miscommunication among a surgical team or faulty recordkeeping. Still, many causes are cognitive - they result from physicians' predispositions to think in a certain way, and from the mental biases that come into play when trying to determine the cause of a patient's symptoms.

One of these biases is anchoring, which means sticking with an initial conclusion and failing to change it based on new evidence. A related problem is confirmation bias, which occurs when a doctor looks for evidence to back up an initial hunch, rather than evidence that might refute it. Another cognitive bias is the gambler's fallacy, in which the doctor assumes that because a condition has occurred more often than usual in recent patients it must occur less often in future patients. There is also an outcome bias, in which the doctor chooses a diagnosis in part because it is the one hoped for.

When misdiagnosis results in serious injury, a worsened condition or death, the patient or their family may consider bringing a medical malpractice lawsuit against the physician and the medical facility involved. A successful malpractice claim can result in an award of compensation for medical bills, disability, pain and suffering.

Source: Minneapolis Star Tribune, "When doctors get it wrong: Misdiagnoses are getting a closer look," Jeremy Olson, Aug. 30, 2015

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