Transcription
One of the weirdest lessons they teach us in medical school is that you should be clear about learning from your mistakes, not your failures. So, what happens in medicine when someone misses a cancer diagnosis is the doctor feels really bad. Sometimes there's a lawsuit.
There's this part of our brain that does something called counterfactual thinking. So, this is the part of our brain that basically when we make a mistake goes back in time and considers alternatives that would not have led to the mistake. This is a fundamental faculty that allows us to learn from our mistakes.
The problem is in a field like medicine if we look at this and we say, "Okay, if a patient comes in with diarrhea, I missed the cancer. Should I start ordering imaging on patients with diarrhea just to be safe?" Most dangerous thing that we say in medicine, "Yeah, we're going to do this just to be safe." And the answer is like, "No, you shouldn't do that." This is what's really confusing for a lot of people.
When you do something, there is a cost to it. I don't just mean a financial cost. So, when you order a test like an MRI, there are these things called incidental findings. Everybody's body is imperfect. We've all got little lumps. We've all got little bits of scar tissue. We've got like veins and arteries that maybe are hypo-occlusive or whatever. And if you go scanning pan scanning stuff, we're going to pick up all this stuff that is actually normal. Okay?
So, one of the weirdest things about medicine is doctors will make mistakes and we should correct for those. But, not all bad patient outcomes are mistakes from doctors.