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What’s Making Us Sick Is an Epidemic of Diagnoses by Dr. Welch, Dr. Schwartz and Dr. Woloshin:
True, and probably the biggest economic threat too. See: Deming’s Seven Deadly Diseases and Health Insurance Premiums Soar Again.
Lack of understanding systems and understanding variation? To me this is a very similar idea to seeing everything as a special cause and addressing each problem with special cause thinking (find the one special cause). Instead, often (97+% according to Dr. Deming) the most effective improvement strategy is to examine the whole system (use common cause thinking). This view in itself, might be a sign that I have Demingities – the propensity to see the excessive focus on special cause thinking everywhere I look.
It sure seems to me this tendency to “over-diagnois” leads to Tampering. Lets assign a special cause to some instance and then implement a counter-measure (it seems to be “take this drug” is a common one). And just as tampering in the management world the “solutions” then create all sorts of problems.
I might be trying to make too big a claim without taking the time to state it well. If this were an article, I would have to spend a great deal more time putting the ideas together much more effectively (and given my past history mean I never do it). But since it is my blog I can post it, as it is – I hope it is useful, if not, maybe some of the links here are useful. There are good things being done in healthcare but the room for improvement is huge, see: blog posts on healthcare improvement and articles on healthcare improvement.
For me, when I read:
I just think: tampering!
Related: Going Lean in Health Care – Health Care Crisis – Control Chart – European Blackout (special cause solution v. common cause)
March 19th, 2007 at 8:39 am
An understanding of theory of knowledge is helpful to counteract errors in thinking….
August 10th, 2007 at 1:23 pm
“They found that 81 percent of these cases resulted in the prescribing of a drug to treat the problem. Only 7 percent of patients received dietary counseling, and only 22 percent were given behavioral therapies such as psychotherapy or stress management counseling…”
February 20th, 2008 at 10:44 am
“The impressive level of detail that CT provides can also cause confusion. In CTs of healthy adults, more than 90 percent of findings are ‘false positives.’…”