The Changing NHS

I've just finished reading this book and enjoyed it a lot.  As well as helping readers to appreciate how different types of doctors think, Dr Groopman draws attention to the kinds of decision errors they are prone to make in the course of attempting to make a diagnosis.

Thinking errors  include:

Confirmation bias - the focusing of attention wholly or overwhelmingly on data that supports a presumed diagnosis and the corresponding tendency to pay less or no attention to data that contradict what is presumed;

Satisfaction of search error - the tendency to stop searching for a diagnosis once something is found;

Vertical line thinking - the constraining of diagnosis as a consequence of using cutting edge technology that must therefore point to a diagnosis

Dr Groopman believes that diagnostic accuracy will be improved if a) patients learn to help their doctors by asking questions that encourage them to think more carefully about diagnostic possibilities and b) doctors learn to welcome this prompt for more reflection.

Currently the NHS  has the expert patient programme  now led by a Community Interest Company . But this programme, as I understand it, is predominantly focused on helping patients with certain long term conditions become more confident and proficient at managing their own condition.

A 30 minute net search didn't pick up much on patients helping doctors reduce diagnostic error rates. The best thing I found was this summary article about ways in which patients might be usefully engaged in improving patient safety on the National Library for Health's site. 

One part of this short note covers how to improve the accuracy of diagnosis but it presupposes the problem is that patients don't give accurate enough information about symptoms or GPs don't listen carefully enough. There is no mention of how patients might help GPs to reduce their decision errors by asking helpful questions.

So perhaps some bright spark somewhere in the NHS ought to start or sponsor a Helpful Patient Programme (HPP)? A programme to help millions of people to become proficient at asking helpful questions to their GP to aid diagnosis.

Maybe if we labelled the Helpful Patient programme a form of social marketing it might be given a fair wind?

Maybe there are 5 or 6 really good questions to ask that often help in lots of diagnostic situations? 

Maybe intelligent articulate patients already play this 'co-producing value' role and millions more could, with just a little help?

What are you thinking (doctor)?

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