Physicians' Diagnostic Overconfidence May be Harming Patients

Cheryl Clark, August 27, 2013

Institutions that notice diagnostic errors need to have a better way to notify doctors when their diagnoses are incorrect, researchers say, because internists' overconfidence in their decisions may be hurting patient care.

Even though they were right only 6% of the time and should have had doubts, internists asked to diagnose tough patient cases express nearly the same strong confidence in their diagnoses as they express for much easier cases, when their accuracy rates were much better, at 55%.

That's the finding of researchers at Baylor College of Medicine who conclude that physicians' "overconfidence" in their diagnostic decisions may be hurting patient care, perhaps because seasoned doctors don't think they need to look harder for an explanation behind a patient's symptoms.

"The point of our study was to figure out what happens to their confidence when they go from an easy case to a harder case; we asked do they adjust their confidence or not, and whether there's overconfidence in their decisions? And that is indeed what we found," says Hardeep Singh, MD, the principal author of a paper published Monday in JAMA Internal Medicine.

Additionally, the researchers found, when dealing with these tougher problem cases, physicians were not more likely to seek opinions from their peers, ask for second opinions, or recommend referrals, although they did request more reference materials to help them determine their patient's illness.


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