When it comes to healthcare, the existence of routines is essential for the hospital, doctors, staff, and patients to function together as a well-oiled efficient mechanism. However, there are some doctors’ routines, which are less efficient and less healthy for their patients. Consider this following example: the good routine is a surgeon’s rounds to see his post-op patients. A bad routine is diagnosing a patient on the spot, based solely on one symptom and not on the broad spectrum of symptoms, the patient may present.
Today, we will see such routines in healthcare that some medical experts can unconsciously engage in. Such habits may lead to errors in diagnosis or the superficial treatment of a patient, therefore we will discuss how doctors can overcome them to the benefit of their patients.
The Problem with Routines
In his career, a doctor sees thousands if not tens of thousands of patients. Depending on his or her specialty, it is obvious that a neurosurgeon will have to clip thousands of aneurysms, while a psychiatrist will treat thousands of depression cases. Specialists may categorize these cases under the umbrella-concept of routine cases and apply the same methods and treatments over and over again.
According to recent studies, overconfidence, lower tolerance to risk, the anchoring effect, search satisfaction, or the bandwagon effect are some of the medical routines all doctors should be aware of and try to overcome, no matter how experienced they are in their respective fields.
The Most Common Healthcare Routines and How You Can Overcome Them
As a medical practitioner, one of your most powerful tools in recognizing and overcoming routines is being aware of them. In order to be safe from such issues and safeguard your patients’ health, we will focus on the following healthcare routines and their countering strategies.
In the medical practice, anchoring refers to a routine mostly present in emergency rooms, where fast diagnosis and intervention are of the essence. Anchoring represents the focus on one particular symptom, sign, or piece of information, or a particular diagnosis early in the diagnostic process and the failing to make any adjustments for other possibilities.
For instance, a doctor focuses only on the patient’s nausea, vomiting, and abdominal pain during flu season, disregarding the presence or absence of other symptoms. In this case, the doctor can routinely treat the patient for gastroenteritis, while in fact, appendicitis is the issue.
How to Overcome Anchoring
In the ER and in any medical setting, the doctor is not alone. While some doctors have the experience of giving an accurate diagnosis in a matter of seconds, they should not let overconfidence overcome them and consult with their colleagues, even if they run against the clock. Ordering full sets of analyses and collaborating with your co-workers at all times is mandatory for a correct medical intervention.
On a personal, mindful level, you should always remember to consider the worst-case scenario, gather enough information, and develop a differential diagnosis alone or together with your colleagues.
2. Search Satisfaction
Another routine in healthcare is treating the patient for only one abnormality found, calling off the search for other related symptoms or disregarding other problems. This routine can save lives most of the time, as doctors choose to treat the most severe (and usually life-threatening) of problems. The decision to choose brain surgery over orthopedic surgery in an accident case may be life-saving for the patient.
However, the search satisfaction routine means stopping after the doctors solved the main problem. Three days post-op the patient may present severe symptoms simply because doctors superficially took care of his broken leg.
How to Overcome Search Satisfaction
If you watched House MD, you surely noticed how diagnosis errors could occur because of this routine. Treating a patient for one major condition may lead to even more health issues for the patient, not to mention discounting other related or unrelated problems.
In order to overcome such routine, you should always ask yourself whether there is something more going on with the patient now that you put the person out of harm’s way.
3. The Bandwagon Effect
This is one of the most common routines witnessed in hospitals, especially in emergency rooms. If a patient becomes a “regular” and everybody knows and already labeled the diagnosis, then it must be right. For instance, a person comes in with severe headaches. Unfortunately, nurses already know the person comes often accusing the same symptomatology only to get some medication.
Let us put it this way: brain surgeons’ salaries are some of the highest ones in the medical practice. A neurosurgeon does not make this kind of payment for believing something you have not researched personally, even if Mrs. X is here the fourth time this week complaining about the same old headache. In other words, even if the nurses ask you to discharge Mrs. X, you need to be aware not to fall under the bandwagon effect.
How to Overcome the Bandwagon Effect
If you consult Mrs. X thoroughly, you may learn she needs brain surgery this time around and thus maybe save her life. Be mindful and always consciously decide to arrive at your diagnosis or differential diagnosis independent of the labels applied by others.
4. The Diagnosis Shortcut
This routine can affect all medical personnel in a hospital, from nurses to residents, and experts. It represents a mindset of sorts, in which medical staff has recent or vivid patient diagnoses readily available in mind and use them to assess current patient problems.
For instance, during the flu season, doctors diagnose tens of flu cases and they tend to treat all patients with fever and myalgia as having the flu. Of course, this can lead to diagnosis errors and mistreatments. On the contrary, you can “see” melanoma in all moles after you recently stumbled upon an irregular light brown nevus that challenged your skills.
How to Overcome the Diagnosis Shortcut
Awareness and second opinions are the main rules to follow in such cases. While you may feel tempted to over-investigate and over-treat or under-treat a patient based on an unexpected recent diagnosis in another patient, you should also refrain from ignoring red flags, symptoms or signs inconsistent with a common, less serious diagnosis simply because they do not fall in the pattern you already considered as correct.
While most healthcare routines like automation and standard procedures and actions are extremely important for the medical system to run smoothly, securing the patients’ wellbeing, some of the doctors’ routines may prove detrimental. Even the best can fall into such habits, so if you are new to the profession, entertain awareness, cooperation, and mindfulness.