What about cognitive errors?!

The latest issue of Time has a review of Dr. Jerome Groopman’s new book “How Doctors Think” which presents the four categories of cognitive errors that doctors make in thinking about their patients’ problems.

Much has been made about “technical errors,” such as mixed up lab orders, and how they contribute to up to 98,000 deaths among American hospital patients each year, and thus the errors of our decision-making, the “cognitive errors,” are totally overlooked.

These errors, Groopman claims, have graver consequences. He learned that about 80% of medical mistakes are the result of predictable mental traps, or cognitive errors, that bedevil all human beings. Only 20% are due to technical mishaps -- mixed-up test results, hard-to-decipher handwriting and the like.

So what are the four cognitive errors doctors make that can harm their patients? Using stereotypes instead of facts to inform decisions, being influenced by having “seen something like this,” a bias toward action over thought and negative emotional reactions to certain patients.

I believe it's hard for physicians to change these types of errors. We should be aware of them and do our best to overcome these mental traps. However, as the neuroscientist Antonio Damasio asserts (and which too many economists were blind to because of their faith in rational motives as the end-all be-all explanation for why we buy what we do), emotion plays a central role in cognition and decision-making.

And human nature, because it relies heavily on emotion and cannot shortcircuit emotion's influence on reasoning and logic, will force physicians to fall back on these errors despite the best of efforts. (I’m making the case for most doctors, as I’m sure there are some exceptions to the rule.)

So I say instead of trying to change fundamental human nature, let's create tools to overcome it. Patients’ health must not suffer because of human folly if it can be overcome. And it can. Technology after all is used to reduce technical errors, so why should it not be used to reduce cognitive errors too?

It seems to be happening under the radar, actually. I wrote about the Isabel computer diagnostic tool before. Of course, more must be done to spur the adoption of these tools as well as to develop new ones. This seems like a big opportunity for entrepreneurs!