When Healthcare Heuristics Become A Problem

On behalf of Peterson, Berk & Cross, S.C.

Many in Appleton may wonder how, with the advances made in healthcare in recent years, can diagnostic errors still be an issue. Medical practitioners have numerous resources at their disposal designed to help them arrive at an accurate diagnosis. Yet despite the tools, diagnostic issues remain the most prevalent type of medical error (with Johns Hopkins Medicine reporting that 80,000-160,000 injuries or deaths occurring each year as the result of them). 

One problem that could potentially be contributing to diagnostic errors is the reliance on heuristics in healthcare. Heuristics are generally accepted practices or “rules of thumb” that practitioners in certain field follow. They typically arise out of best practices within an industry. This explanation not only makes heuristics seem harmless, but also beneficial in conducting one’s business. Heuristics are indeed helpful in healthcare, as they set to establish the standards against which clinicians are judged. Yet it is when doctors rely too heavily on them that diagnostic errors often arise. 

The Agency for Healthcare Research and Quality has identified four scenarios where heuristics might often lead healthcare providers astray. These are: 

  • Availability heuristics: A doctor allowing past experiences to bias their opinion on a current case
  • Anchoring heuristics: A doctor relying on their initial diagnostic impression despite subsequent evidence contradicting it
  • Framing effects: A doctor allowing collateral information (such as a patient’s demographic information) to bias their opinion
  • Blind obedience: A doctor relying too heavily on expert opinion

A provider’s over-reliance on heuristics will often be evidenced in their documentation. Phrases such as “despite clinical evidence to the contrary” or “in accordance with current popular opinion” might indicate that a doctor is relying on something outside of patient’s current clinical indicators to form their opinion.