Preventing Misdiagnoses in Clinical Practice

Presentation Description / Summary: Diagnosis is considered the pinnacle of cognitive skill in medicine, being both essential for successful outcome and yet extraordinarily difficult to master. In human medicine, a recent report found that almost everyone who goes to the doctor will experience a misdiagnosis in their lifetime, a key factor in ~50% of litigation against doctors. In this session we'll talk about the two ways we come to a diagnosis: "thinking fast" (known as system-1 reasoning) is the rapid, intuitive and non-analytical approach to identify common diseases, and used in the majority of cases by experienced clinicians, whereas "thinking slow", or system-2 reasoning, uses an analytical, hypothesis-driven, problem-based approach to diagnosis and is essential for patients with complex or multisystem disease. Given the realities of veterinary practice, system-1 reasoning is an essential skill but it comes with a much higher risk of subconscious cognitive biases that make misdiagnosis more likely. We will go over some of the most common examples of cognitive biases, discuss how they apply to veterinary medicine, and identify some simple strategies that can be incorporated in a matter of seconds into every day, high-paced practice. Then we'll review the fundamentals of the problem-based approach to diagnosis and hone some skills that will improve your ability to pursue a diagnosis in cases where pattern recognition is insufficient.