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What do you do if a physician's decision seems illogical?

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When you're working alongside physicians, sometimes you might encounter a decision that seems illogical. It's important to approach this situation with respect and professionalism, as the stakes in healthcare are incredibly high. A physician's decision may be based on a complex web of medical knowledge, patient history, and nuanced understanding of the condition at hand. As a non-medical professional or even as a colleague, it can be challenging to understand the reasoning behind certain medical decisions. However, it's crucial to remember that patient safety and care quality are the top priorities.

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1 Seek Clarification

If a physician's decision puzzles you, the first step is to seek clarification. Approach the physician privately and express your concerns respectfully, ensuring that you're not challenging their expertise but rather seeking to understand their perspective. Use open-ended questions to facilitate discussion, and listen actively to their explanations. This can often illuminate the rationale behind a decision that initially seemed illogical and can help you learn more about the complexities of medical decision-making.

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Eric Marcotte, MD, MBA

Physician executive for growing Midwest health system
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This is solid advice about understanding the “why” of a decision. It is also important to seek to understand the decision itself fully, and that should usually come first. Even binary decisions, such as prescribing or not prescribing a certain treatment, often have nuances of timing and data collection that may not be obvious. Decisions entirely outside of the medical field are likely to be impacted by the mental habits and training required to become a physician. A desire to be prepared, the need for data authentication, a preference for prevention, and habitual risk avoidance can all impact life decisions from investment choices to car maintenance.

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2 Collaborate Closely

Effective teamwork in healthcare relies on collaboration. When faced with an illogical-seeming decision, work closely with the physician and other healthcare team members to understand the decision-making process. This collaborative approach not only helps in aligning everyone towards a common goal but also ensures that all viewpoints are considered. Remember, a multi-disciplinary team approach can lead to better patient outcomes and can sometimes reveal the logic behind a seemingly perplexing decision.

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3 Consider Experience

Physicians often draw from a deep well of experience when making decisions. If you're questioning a decision, consider the physician's experience and whether it may be informing their choice in ways that aren't immediately apparent. Experience can provide intuitive insights that might not be strictly textbook-based but are nonetheless valid. Acknowledging the value of clinical experience can help you appreciate the decision-making process from a different angle.

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Nabil Ebraheim, MD

Orthopaedic Surgeon Toledo Ohio
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Considering the experience of others is vital because it offers us a broader perspective that extends beyond our personal encounters. Other people's experiences act as a collective wisdom bank, providing insights that we may not have the opportunity to learn firsthand. When we value and learn from the experiences of others, we essentially tap into a diverse array of life lessons, which can guide us in making more informed decisions. Even when the experiences of others don't seem perfect or align with our initial beliefs, there's value in exploring them. This diversity in experience fosters empathy and understanding, helping us to see the world through different lenses.

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Sky C.
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Absolutely, I completely agree with your perspective on the importance of considering the experiences of others. Embracing the variety of experiences that people have to offer can enrich our own understanding of the world and broaden our horizons. It allows us to cultivate empathy, respect different viewpoints, and learn from the wisdom accumulated by others. By being open to diverse experiences, we not only enhance our decision-making process but also foster a more inclusive and compassionate society. Thank you for highlighting this valuable aspect of personal growth and mutual understanding.

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4 Evaluate Outcomes

Sometimes, the logic of a decision is best understood by looking at outcomes. If possible, monitor the patient's progress following the physician's plan. Outcomes can provide tangible evidence of whether a decision was sound, even if it initially seemed counterintuitive. This evaluation can be a learning experience, providing insight into the effectiveness of different approaches and reinforcing the importance of evidence-based practice.

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5 Respect Autonomy

Physicians have the autonomy to make clinical decisions based on their professional judgment. While it's important to voice concerns if you believe a decision could compromise patient safety, it's equally important to respect this autonomy. In cases where the physician's decision is supported by their expertise and patient consent, it may be necessary to trust their judgment and observe how the situation unfolds, even if you don't fully understand the logic behind it.

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Alon Kol

Clinical Associate Professor- Podiatry University of Arizona College Of Medicine/Co-director Southern Arizona Limb Salvage Alliance (SALSA)
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As long as you believe that the physician is trying their best to provide good care to their patient it is usually reasonable to rely on physician judgement. In most situations the responsibility for the patient sits with the physician. When you are entrusted with that level of responsibility it seems equally important to have the autonomy to care for them as well. I would often tell students and residents that if you have a concern your responsibility is to bring it up and discuss it with the physician once. After you have had the opportunity to raise the concern your job is done. The physician should incorporate the new information when they are making their decisions. At that point you need to trust that they will.

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DR A PRAGATHESWARAN PRAGATHEESH

MEDICAL DIRECTOR .MADURAI MEDICAL CENTRE.FORMER CHIEF CIVIL SURGEON.CHIEF ADMINISTRATIVE MEDICAL OFFICER. TAMILNADU GOVT.CONSULTANT ENT SURGEON at APOLLO HOSPITALS , MEDICAL DIRECTOR ,GURU HOSPITAL.
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No point in respecting autonomy since a wrong and illogical decision may end up in loss of function or life of the patient which in turn would have serious consequences on the banner of the institution.

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6 Continue Learning

Lastly, use this experience as an opportunity for continuous learning. Healthcare is an ever-evolving field, and staying informed about new developments and clinical practices is crucial. Engage in professional development and seek out educational resources to broaden your understanding of medical reasoning. This proactive approach will not only enhance your collaboration with physicians but also contribute to your personal growth within the healthcare environment.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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What do you do if a physician's decision seems illogical?

1

2

3

4

5

6

7

1 Seek Clarification

2 Collaborate Closely

3 Consider Experience

4 Evaluate Outcomes

5 Respect Autonomy

6 Continue Learning

7 Here’s what else to consider

Working with Physicians

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What do you do if a physician's decision seems illogical?

1

2

3

4

5

6

7

1 Seek Clarification

2 Collaborate Closely

3 Consider Experience

4 Evaluate Outcomes

5 Respect Autonomy

6 Continue Learning

7 Here’s what else to consider

Working with Physicians

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