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The first patient who died on my watch was an older man with a faulty heart. We tried to slow it down with treatment, but it suddenly stopped beating completely. Later, whenever I would have a case like that one, I found myself second-guessing my clinical management. However, it turns out that thinking twice may actually cause more harm than good.
In a working paper, Emory University researchers found that when doctors delivering a baby have a bad result, they are more likely to switch to a different delivery method with the next patient, often unnecessarily and sometimes with worse results.
Because doctors make so many decisions that have serious consequences, thefalloutfrom second-guessing appears especially large for us. A 2006 study found that if a patient had a bleed after being prescribed (开药) warfarin, the physician was about 20% less likely to prescribe later patients the blood thinner that prevents strokes (中风). However, if a patient was not on warfarin and had a stroke physicians were still no more likely to prescribe warfarin to their other patients.
These findings highlight interesting behavioral patterns in doctors. In the blood-thinner study, doctors were more affected by the act of doing harm (prescribing a blood thinner that ended up hurting doctors were more affected by the act of doing harm(prescribing a blood thinner that ended up hurting a patient) and less affected by letting harm happen (not prescribing a blood thinner and the patient having a stroke). Yet a stroke is often more permanent and damaging than a bleed.
But this phenomenon is not unique to medicine. ''Overreaction to Fearsome Risks'' holds true for broader society.
For instance, sensational headlines about shark attacks on humans in Florida in 2001 caused a panic and led the state to prohibit shark-feeding expeditions. Yet shark attacks had actually fallen that year and, according to the study, such a change was probably unnecessary given the extremely small risk of such an attack happening.
Humans are likely to be influenced by emotional and often irrational (不理性的) thinking when processing information, bad events and mistakes. As much as we don't want to cause an unfortunate event to happen again, we need to be aware that a worst situation that can be imagined doesn't necessarily mean we did anything wrong. When we overthink, we fail to rely on thinking based on what we know or have experienced. Instead, we may involuntarily overanalyze and come to the wrong conclusion.
I have treated dozens of patients who presented with the same illnesses as my first patient, who died more than a year ago. Instead of second-guessing myself, I trusted my clinical instinct (本能) and stayed the course. Every one of those patients survived. You should trust your instinct in your life, too.