Rule #1 of emergency room diagnostics

An excerpt from Malpractice: A Neurosurgeon Reveals How Our Health-Care System Puts Patients at Risk.

It is not possible to live life in a way that every choice and decision awaits a definitive, double–blind study with a statistically significant population of subjects to determine the best way to proceed. As a matter of fact, very few of our problems are resolved that way. We often reach conclusions emotionally and then invoke logic and reasoning to justify them. Instead of approaching problems by stating a hypothesis and then testing it against evidence, we often unconsciously begin with a conclusion or belief and then seek evidence to confirm it. In medicine, as elsewhere, this is known as confirmation bias. This is a dangerous intellectual trap for a physician to fall into.

Headaches are one of the most prevalent symptoms presented in clinical practice. The migraine headache is common, and is often the doctor’s first consideration before she analyzes other potential causes of the headache.

This is called pattern recognition. The doctor has seen this symptom countless times and is quick to recognize it. If this diagnosis is correct, it saves time, eliminates a lot of unnecessary testing and additional patient anxiety, and measures can be quickly taken to safely alleviate the pain.

What if it’s not a migraine? What else could it be?

Read the full article here.