How to be a Better Doctor: Recognizing How Cognitive Biases Shape-and Distort-Clinical Evidence.

Abstract

Rather than the absence of any harm, it is the expectation of an overall benefit of a medical treatment that is the foundation of the implicit doctor-patient contract. In the context of an expectation of efficacy, powerful cognitive biases can blind clinicians to obvious signs that a treatment is not helping, or may even be harming their patients. With examples from medical history and current clinical controversies, this paper examines how systematic psychological biases can distort not just individual decision making, but perceptions of the evidence base upon which clinical decisions are built. These distortions can perpetuate harmful practices in medicine long after the objective evidence points in a different direction. By becoming aware of these biases and the way they shape perceptions of the evidence base, doctors can reduce the negative impact they may have on the patients in their care.