Articles | Behavioural science
By Lisa M Lee & Dr. Hal Willaby
Zimbardo, Philip G
Doctors don’t always make the ‘right’ decision for the ‘right’ reasons.
This was the premise of our first article, “Rational Irrationalists: The hidden truths about how doctors make decisions.” There, we used a behavioural science framework to unpack the thought processes that lead to seemingly irrational decision-making in diagnosis and therapy choice, with several home truths to keep in mind:
People do not always make rational decisions. They don’t always weigh every option up, calculate the probabilities and go for the option with the best utility. Life, time, stress, worry and desire get in the way.
This applies to medical doctors – largely because they are people too! In fact, their working environments are fertile grounds for heuristic ‘System 1’ decision-making. They’re frequently making complex decisions under time pressure, where the information available isn’t always complete or reliable.
Heuristics aren’t ‘bad’, but they can lead to sub-conscious errors in decision making. They are speedy, economical and often develop with expertise (for example, Klein’s Recognition Primed Decision-Making model). However, when heuristics are used they can lead to systematic biases. And importantly, these biases will not be apparent to the doctor making the decisions, as ‘System 1’ thinking, like all automatic processes, is not open to self-analysis.