Doctors aren’t perfect, and that includes the ones who practise medicine. Diagnosis mistakes are common among them. Though the frequency of such mistakes is difficult to gauge, autopsy investigations give one hard-to-dispute metric: 10–20% of cases had “significant diagnostic differences” (Graber 2013). Other kinds of research have produced similar results (see Graber 2013). Doctors have been known to make a series of egregious errors when it comes to basic medical knowledge.
Women who had a positive mammography were questioned by gynaecologists in one research if they were more likely to get breast cancer rather than those who had a negative one. To get the correct response, they were given a set of questions with four possible answers, one of which was accurate; they were also provided statistical information that would have made the work simple. Only 21% of the physicians got it right, thus they fared a little worse than expected if they had picked the answer at random.
Blame has a high price
Defensive medicine is a significant side effect of placing blame on doctors when they make mistakes. Because of the dramatic nature of underdiagnosis and treatment harm, they are often more easily understood than overdiagnosis and treatment harm. By erring on the side of caution, doctors might reduce their chances of being sued for negligence. Between $650 billion to $850 billion is spent annually in the US on “defensive medicine”.
As a result of the focus on blame, doctors are harmed as a consequence. Being a doctor is a gruelling job. Doctors suffer from depression and exhaustion on a regular basis, and the suicide rate among doctors is alarmingly high—41% for males and 127% for women (Schernhammer 2004). In part, this might be attributed to a sense of shame and responsibility for making mistakes, or even for taking risky actions that end in disastrous results. In a less evident way, the modern medical establishment tends to marginalise and disregard a critical healthcare resource: the patient, when it places too much emphasis on the physician’s responsibilities.
The Doctor as an Authority
Today’s healthcare system is still very much a dictatorship, with Olympians in white coats telling patients what to do. There is nothing more passive than the title of “patient,” which you automatically receive when logging into the system (oed.com). As a doctor, you have access to a set of abilities and information that is often idealised in popular culture because of the high social position that comes with it. One who must be obeyed under penalty of death, the doctor is an unapproachable authority figure for patients.
Because of this, Wegwarth and Gigerenzer call the trust-your-doctor heuristic, the decision rule most of us follow when it comes to our medical needs: contact your doctor and just comply with her directions, which is not surprising (2013). Because the physician-patient knowledge gap is believed to be enormous, the physician bears the full weight of responsibility for making the proper decisions. A controlling doctor and a willing patient are still shown in our minds, despite the fact that informed consent was introduced in the 20th century to defend patient autonomy. With this framework in place, we risk losing out on patient-centred solutions because we are constrained by them.
Taking The Patient Seriously
Patient participation in medical choices is not only about protecting patients’ rights; rather, it’s a way to improve medical decisions themselves. Over a previous couple of centuries, medicine has experienced a progressive movement towards a focus on the patient in numerous ways, through informed consent and, more recently, the notion of shared decision-making. It’s a good thing that this is going on.
Doctors might be incorrect at times. Patients may be correct in some cases. In an authoritarian paradigm, doctors will override their patients’ accurate judgements with their own incorrect ones when these scenarios overlap. In a perfect world, a patient’s sound judgement would have caught the doctor’s error and corrected it. Patients’ resources should be taken into account while making medical decisions, a step toward this aim.