Shortcuts in Medical Decision-Making: Good or Bad?

Like anyone, health care professionals take mental shortcuts to get through a busy day. Building on lessons learned from past experiences, mental shortcuts seemingly help us (1) make more decisions; (2) act in a more efficient manner; and (3) reduce the room for error. Mental shortcuts are a good thing.

Or are they?

In a recent article from Science, a health economist cited research suggesting that obstetricians sometimes use heuristics, or mental shortcuts, in ways that could potentially harm the mother and baby in the delivery room.[1] The data suggested that where OBs experienced complications during one patient’s delivery, they were more likely to switch to the other mode of delivery for the next patient, regardless of the medical situation. For example, a complication during a vaginal delivery increased the likelihood of a subsequent caesarean delivery, and vice versa. This research also found correlation between heuristic decision-making and increased poor outcomes for the patient and/or the baby.

Health care providers need to be attuned to the risks associated with heuristic decision-making.

To combat the potential risks of these “mental shortcuts,” the author suggests building algorithms into electronic health records systems to assist physicians with important clinical decision-making. These algorithms would flag physician decisions that fall out of the norm, identify patients who could benefit from a particular course of action, or summarize information in a way that makes it easier for the physician to digest.

Have you and your team discussed whether the best decision-making is being employed? Are your electronic health record systems taking steps to assist the decision-making process of your health care providers?

Critical thinking must always be the basis for good health care. But if you have questions about overcoming mental shortcuts in medical decision-making, please contact us. We’re here to help.

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[1]
Manasvini Singh, M.D., “Physicians Flawed Heuristics in Delivery Room; Complicated Childbirths Can Influence Later Decision-Making,” Science (October 15, 2021).

Lisa J. Russell

Lisa J. Russell

Lisa J. Russell is a trial attorney and partner at Waranch & Brown. Her practice focuses primarily on medical malpractice and general liability defense. Mrs. Russell has litigated medical malpractice cases in the District and Circuit Courts of Maryland as well as the United States District Court for the District of Maryland. She has argued before the Maryland Court of Special Appeals and handled several Petitions to the Maryland Court of Appeals. She has been admitted Pro Hac Vice to various trial level Courts in Pennsylvania, where she has been involved in the defense of numerous medical malpractice cases.