WWWWF:
A Look at Wichita Falls on the Web

Sorry about the unexpectedly long Memorial Day hiatus. Let's hop back into things.

Chapter 3 more than anything reinforces the importance of an informed patient, and not so much because people should know so much about their ailments so they can relay a lot of insight to their caregivers (though that's a good idea, too). No, what really sticks with me in this chapter is just how often someone had the guts to stick to their guns and not back down from wanting procedures despite the grumblings of their doctors. Some folks are born with that skill, but it's something everyone can develop once they have a little knowledge in them.

What Chapter 3 really looks at the way doctors and hospital operations can actually interfere with how healthcare gets delivered. The mental shortcuts doctors use can be skewed.

For one thing, there's the fault of "availibility" error, in which physicians "the tendency to judge the likelihood of an event by the ease with which relevent examples come to mind." So, if the area has a lot of allergies, then doctors maybe more apt to say an ailment is an allergy just because so many have come through the office. Then come tricks called "confirmation bias" and "anchoring," essentially selectively accepting facts that backup a hunch while downplaying contradictory notions and then hitching a diagnostic to a single hypothesis without considering other ideas. It adds up to situations in which misdiagnosis occur.

Battling against such problems comes from not being timid. Groopman offers some good advice on this front:

If the physician is distracted, frequently interrupted by other doctors, nurses, social workers, or the administrative staff as he interviews or examines you, the steady flow of his thinking may be diverted in the wrong direction. There is similar cause for concern if the physician seems rushed or breaks in as you answer a question, so that you feel he is not letting you tell him everything about your symptoms ...So a fair question to ask an ER physician is: What's the worst thing this can be? The question is not a sign of neurosis or hypochondria; in fact, residents are trained to keep it in mind with each patient they see.

Plus

Another way that laypeople can focus a doctor's attention is to ask: What body parts are near where I am having my symptom? This sounds elementary, but this query can help avoid "yin-yang out" errors

The yin-yang thang refers to doctors thinking every procedure that should be done has been done without making sure some new avenure gets explored. And finally

"No one -- no doctor, no patient -- should ever accept, as a first answer to a serious event, 'We see this sometimes,'" Alter said. "When you hear that sentence, reply, Let's keep looking until we figure out what is wrong or know the problem has passed."

Patients have to be on the look out because so much stuff can steal the focus they need from their providers.