CLINICAL WRONGOLOGY©
M. HEMADRI
Substantial activity in clinical medicine is not performed on the basis of clear unequivocal evidence
Substantial activity in clinical medicine cannot after care delivery find evidence to back it
Substantial clinical care is delivered incompletely
Substantial amount of errors are found in the delivery of care
Substantial numbers of clinicians are either unable or unwilling to accept the above
In
effect there is plenty or wrongness in theory, plenty of wrongness in
practice and blindness to wrongness in clinical medicine. The wrongness
is affecting patients by causing poor experience of healthcare,
avoidable complications and avoidable deaths. Clinical wrongness is also
affecting doctors and other clinicians causing variations in practice,
restriction in the ability to practice appropriately and punishments for
poor clinical performance.
There
will be a day in the future when clinical medicine will practiced on
the basis of proven science. We will truly rejoice on that day. Till
that day arrives clinicians will need an approach that will help in
appreciating, understanding and coping with the wrongness that is
prevalent. The study of that approach is Clinical Wrongology.
Clinical
Wrongology will remove the blindness to wrongness. It will make
clinicians appreciate that there is wrong, wrongness and errors
everywhere and these are normal to general life and clinicians are not
exempt from this. Clinical wrongology will then encourage clinicians to
cope with the wrongness around them and will show some methods to
practice within the wrongness atmosphere with a view to increasing
safety, quality and decreasing cost.
Clinical Wrongology, the new specialty in healthcare is now declared open.
Watch this blog as there will be more on this subject.
Clinical Wrongology, the new specialty in healthcare is now declared open.
Watch this blog as there will be more on this subject.
©M HEMADRI
Follow me on twitter @HemadriTweets
PS: While there are philosophers who
are masters on the subject of wrongness and great experts in the study of error, my inspiration for thinking
about wrongology and clinical wrongology was from 'Being Wrong', Kathryn
Schulz's brilliant book. Kathryn if you are reading this blog I hope
you do not mind me calling myself a Clinical Wrongologist, (perhaps the
worlds first and only one till date); having vainly given myself that
title I could be motivated to live up to it; unless I am totally wrong
on that!
NB: Persons in healthcare who want to be involved and contribute to this effort, please leave a comment with a means of contacting you or send a direct message to me on twitter.
6 comments:
Completely agree in all you said in your blog. I like the term clinical wrongology.
Fear of missing a diagnosis in clinical medicine when approaching a patient makes many doctors to depend on numerous (unnecessary) investigations, time etc.
The fear will not be dispersed unless there is a mentor or guide whom one can approach in case of uncertainity.
The mentor or guide is usually a person who in the eyes of the seeker an expert in that field. However not everyone needs to be an expert to make right decisions
I am unsure when the day will come when everything will proved/disproved in clinical medicine
I dont think it will be in lifetime of clinical practice
Pawan Lekharaju
Email: pawan.lekharaju@gmail.com
Being open to the fact that what is right today can be wrong tomorrow requires courage and the ability to deal with one's own vulnerability and this is something that is very difficult to share during 'shared decision making exercises' with other stakeholders in health care such as patients, relatives and even other health professionals. Thanks for your efforts in this direction. best, rakesh
Thanks Pawan and Rakesh for your comments.
I agree it is not easy but I hope that we will get to a shared decision making method so that even the non-experts can make the right decisions
I will write on this again.
Thanks for a very insightful post.
As doctors we need to recognise our shortcomings, and the fact we often treat espite the lack of evidence is a major one.
An opportunity we currently have is to use technology to enable us to build our evidence base incrementally from real time data we collect in clinical practice. For me "big data" in medicine is in gathering clinical data from the entire healthcare system and using it for real time clinical decision support.
I look forward to further discussion on this topic.
Dr George Margelis
george@georgemargelis.com
www.georgemargelis.com
Thanks Dr Margelis for your thoughts on big data and medicine. It will surely interact with you on this one.
Bravo, Dr Hemadri. I salute your "opprobrium ';most appropriate.Ethical" pitfalls" are now effectively marketed as "pearls".
Silence is most discreet. "MUM'S THE WORD".
Tace is latin for "be silent", and candle is symbolic of light.It means "keep it dark", do not throw light upon it.
"Tace , madam, is Latin for a candle"....It was customary at one time to express disapprobation of a play or an actor by throwing a candle on to the stage and sometimes causing the curtain to be drawn.
Major General (Dr) Bikash Mohanti AVSM (Veteran)
bikashmohanti@gmail.com
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