Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

False assumptions and clinical errors in modern medical practice

George Lundberg, MD and Clifton Meador, MD
Physician
September 18, 2011
46 Shares
Share
Tweet
Share

Here are 22 false assumptions, practice failures, and everyday clinical errors that we believe are common in modern medical practice:

1. Lack of appreciation of the phenomenon of physician persuasion and its hidden power. The placebo effect is scientific, potent, and worthy of use.

2. Lack of understanding of the power of prevalence or pretest probability in the diagnostic process, leading to frequent false positives and “overdiagnosis” of nonexistent diseases.

3. Lack of understanding that many disease processes are gradual and progressive — not “on or off” signals; analog and not digital. This leads to great confusion about when to diagnose and treat. For example, at what percent stenosis is an artery “diseased” and in need of treatment?

4. Incorrect assignment of reductions in death rates and increasing life expectancy to curative medicine rather than to preventive efforts.

5. Medicine has a tendency to remove many physicians from relying on direct experience and personal observations and replace this with a reliance on indirect information. This leads to an over-reliance on lab and imaging findings by both patients and doctors.

6. Lack of long-term clinical outcome data, stratified by gender and age, leading to an inability to obtain a truly informed consent.

7. The mind-body dichotomy, present since René Descartes in the 1600s, holds erroneously that the mind and body are completely separated. This false separation leads us to believe that the lack of evidence for disease in the body of a symptomatic patient confers a diagnosis of mental disease: Thus the non-helpful statement to the patient, “Don’t worry, it’s all in your head.”

8. Lack of appreciation for what is scientifically established versus what is still in the thought stage of development.

9. A failure of medicine to recognize what it can effectively treat and what it cannot, and admitting that some diseases have no effective treatment.

10. Failure to recognize that the fields of human biology and clinical medicine overlap but do not coexist. Schools of medicine are becoming more schools of human biology and less schools of clinical medicine.

11. Absence of a test that will distinguish well from sick. The lack of a test leads to the erroneous assumption of sickness as the rule of thumb for almost all patients.

12. Lack of a blood or urine test that can measure mental status. Dementia can be missed in up to 20% of admissions to hospitals.

13. Lack of full understanding of the intense secondary gain of illness.

14. Fallacy of the first lesion found being assigned importance, whether or not it is the cause of the symptoms.

15. Fallacy of any lesion found being sufficient to explain symptoms.

16. Failure to stop a drug or treatment when it is not helping.

17. Failure to identify what abnormality or test result is to be followed to determine success or not, when someone is being treated.

18. Failure to look for little signs of improvement and stick with the treatment rather than change it too soon.

19. Failure to know a patient well enough to know what their wishes are in terminal or hopeless situations.

20. Failure to recognize and advise the family when a condition or situation is futile and should move to palliation and comfort care.

21. Failure to keep the number of drugs to a minimum.

And, number 22, perhaps the most important to today’s society:

22. An exaggerated and unfounded fear of malpractice suits with abdication of professional responsibility just to avoid any chance of being sued.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association and Clifton Meador is an endocrinologist on the faculties of Vanderbilt and Meharry Medical Schools.

Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.

Prev

Why health reform will not be repealed

September 18, 2011 Kevin 12
…
Next

A PhD who's no longer a doctor in medical school

September 18, 2011 Kevin 7
…

Tagged as: Primary Care, Specialist

Post navigation

< Previous Post
Why health reform will not be repealed
Next Post >
A PhD who's no longer a doctor in medical school

More by George Lundberg, MD and Clifton Meador, MD

  • a desk with keyboard and ipad with the kevinmd logo

    How prevalent are false diagnoses of disease?

    George Lundberg, MD and Clifton Meador, MD

More in Physician

  • The shifting landscape of gastroenterology manpower and compensation

    Brian Hudes, MD
  • Surgical procedures for inpatients: Addressing socioeconomic urgencies

    Deepak Gupta, MD
  • I’m a doctor, and I almost died during childbirth

    Bayo Curry-Winchell, MD
  • A message of hope for physicians

    Kim Downey, PT
  • From aversion to office politics to embracing independence

    Osmund Agbo, MD
  • Navigating medical decision-making: Embracing limits and growth

    Benjamin Wade Frush, MD
  • Most Popular

  • Past Week

    • Ethical considerations in medicine: unity and open discourse

      Andrew Zywiec, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • For newer doctors, avoid lifestyle inflation

      Amarish Dave, DO | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Chronic health issues and homelessness

      Michele Luckenbaugh | Policy
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
    • 1 in 4 attempt suicide: the persecution of autistic physicians

      Patricia Celan, MD | Physician
  • Recent Posts

    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Exploring disfigurement and self-worth

      Kathleen Watt | Conditions
    • AI is living up to its promise as a tool for radiology

      Hoag Memorial Hospital Presbyterian | Tech
    • The shifting landscape of gastroenterology manpower and compensation

      Brian Hudes, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • 'Con Man' Gets Another Top Hospital Job, This Time at Penn Medicine
  • TikTok Dinged for Misinformation; BRCA Risk Overestimated; Cheers for Oncology
  • Flawed Rules in No Surprises Act Hurt Doctors and Patients, Experts Say
  • IG Live September 25: When the Healers Need Healing

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • Ethical considerations in medicine: unity and open discourse

      Andrew Zywiec, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • For newer doctors, avoid lifestyle inflation

      Amarish Dave, DO | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Chronic health issues and homelessness

      Michele Luckenbaugh | Policy
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
    • 1 in 4 attempt suicide: the persecution of autistic physicians

      Patricia Celan, MD | Physician
  • Recent Posts

    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Exploring disfigurement and self-worth

      Kathleen Watt | Conditions
    • AI is living up to its promise as a tool for radiology

      Hoag Memorial Hospital Presbyterian | Tech
    • The shifting landscape of gastroenterology manpower and compensation

      Brian Hudes, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

False assumptions and clinical errors in modern medical practice
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...