Episode 28: Donald Redelmeier

Described by the New York Times as the “leading debunker of preconceived notions in the medical world”, Don Redelmeier is an award winning researcher, teacher, and clinician.  Enjoy our conversation with Dr. Redelmeier where we discuss pitfalls in clinical reasoning…as well as New Zealand idioms…

Click here for the New York Times profile of Dr. Redelmeier.

Here’s an excerpt from The Undoing Project: A Friendship That Changed Our Minds (W.W. Norton & Co., 2016) by Michael Lewis (Moneyball) about Daniel Kahneman and Amos Tversky, featuring the “unsung hero” of the book, Don Redelmeier.

Here’s an excellent 2005 article from the Annals of Internal Medicine on the cognitive psychology of missed diagnoses.

Episode 26: STC from the Clinical Problem-Solving series in NEJM

 

While waiting for another of our home-grown cases we decided to do a STC using a published case from the Clinical Problem-Solving series of the New England Journal of Medicine.

Let us know what you think of this format!

Leave us a comment here on the website, or on Facebook

www.facebook.com/imreasoning

or now you can make noise at us on Twitter.  Our handle is @IMreasoning

Episode 25: Revisiting Dual Process Thinking

Do all diagnostic errors occur because we’re rushing, and prematurely jumping to conclusions? Can we course-correct by simply slowing down and by being mindful of our own inherent biases?

Geoff Norman and his colleagues review the literature to try to answer these and other questions about where errors in clinical reasoning come from.

The Causes of Errors in Clinical Reasoning: Cognitive Biases, Knowledge Deficits, and Dual Process Thinking

And get your own shiny Cognitive Bias Codex Poster here…https://www.designhacks.co/products/cognitive-bias-codex-poster

Please write us with comments and feedback here, or on Facebook at https://www.facebook.com/IMreasoning

and send us your STC cases to imreasoning@gmail.com

Episode 24: Myths Part 2

Doctors should always strive to present themselves as unbreakable to their patients…  All doctors are smart…  All patients have a definitive diagnosis…

Believe it or not, versions of these ideas, and many others, are pervasive in our medical education institutions, and to varying degrees are believed and practiced by doctors everywhere.

In this episode, we debunk and discuss our favourite myths. Enjoy!

Don’t forget to write us with feedback on our Facebook page at https://www.facebook.com/IMreasoning

and write to us with your STC cases to imreasoning@gmail.com

Episode 23: Myths of the Physical Exam Part 1

Transillumination of the sinuses? shifting dullness? the puddle sign?

In this episode we poke fun and debunk our favourite “useless” physical exam manoeuvres that we continue to teach our medical students.  We couldn’t cover all of them in one go, so stay tuned for more…

Try the app DxLogic on the iPhone to have a quick reference to the utility of many studied history features and physical exam manoeuvres.

Also, check out JAMA’s series of articles entitled “The Rational Clinical Exam“. Another great resource is Steven McGee’s book, “Evidence Based Physical Diagnosis“.

Finally, in reference to our previous episodes about Larry Weed and his Problem Knowledge Couplers, here’s the response from Larry and his son, Lincoln to some of the concerns we raised:

Larry, Lincoln Weed response

 

Episode 22: Diagnostic Error in Medicine 2016 – Los Angeles

Enjoy a short episode where we bring you our highlights of the DEM2016 conference in Hollywood, Los Angeles.

This is a very well-organised, relevant, and creative conference, and it just gets better every year.  Consider attending the next DEM conference.  Either in Boston in one year, or come to visit our neck of woods for the first Australasian DEM in Melbourne in May! You can get more information on the SIDM website:

http://www.improvediagnosis.org

 

 

 

Episode 21: STC with Anthony Jordan

Enjoy another instalment of Stump the Chumps.  Friend and colleague Anthony Jordan presents a case of angio-edema…and other symptoms.

Be the next one to present a STC case!  If you’re willing to record your voice, write to imreasoning@gmail.com with a snippet of your case, and we will be in touch.

Remember to comment on this episode either on our Facebook page www.facebook.com/IMreasoning or on our webpage www.imreasoning.com

Also, if you have a chance you could rate us on iTunes to help spread the good word…

Episode 20: Medicine in Denial – Part 2 – An interview with Larry Weed

As promised, our latest episode brings you an interview with Dr. Larry Weed.  We hear from the man himself about his vision for a healthcare revolution.

We would love to hear from you about this episode.  Do you think we are doing things right? Or do you think the way we go about diagnosis is fundamentally wrong?

If you’d like to read the complete treatise on Dr. Weed’s vision for revolutionizing our health care and medical training systems, here’s a link to his book Medicine in Denial discussed in the podcast.

With regard to contacting the (US) National Library of Medicine to advocate for a ‘knowledge net’ as discussed by Dr. Weed and his son, Lincoln, Lincoln offers this: Thanks very much for offering to contact the new director of the National Library of Medicine.  She is Patricia Brennan, whose current email is patti.brennan@nih.gov.  Her training is in nursing and engineering, and she is not an MD — which may be a perfect background for recognizing the potential in Dr. Weed’s ideas.  See this interview with her, where she refers to “the Library’s sweet spot…and that is delivering information back to individuals…”