Common biases
Volume and complexity expose clinicians to systematic bias.
Here the authors survey the biases that bend clinical judgement, treating exposure as a function of how many decisions you make and how complex they are. They open with decision fatigue, citing surgeons who booked a third fewer elective operations late in a list, then use decision trees to show how complexity multiplies the ways a choice can go wrong. The familiar advice to think horses not zebras introduces availability bias, followed by priming, anchoring, planning bias and the overconfidence of Dunning-Kruger. The fundamental attribution error is shown quietly corroding teams. They close on debiasing, more thinking time, teaching and checklists, while admitting the evidence is thin and varies by person.
Three takeaways
- Tiredness pushes clinicians toward fast thinking, where clues get missed
- The attribution error erodes teamwork by misreading colleagues
- Documented implicit bias tracks with race, weight and gender
Reflection
Questions for this chapter
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