Decision fatigue and your medical care

decision fatigue

When you visit your doctor, you expect to receive quality care that aims to lessen your pain or discomfort. Indeed, doctors are held to a high standard of care that they must adhere to when treating every single one of their patients. Nevertheless, even doctors sometimes fall prey to physical and mental exhaustion as the day goes on, resulting in rushed consultations, inadequate treatment, unnecessary prescriptions, and various other medical lapses. By the end of the day, many doctors find it difficult to perform at their best, increasing their chances for errors and medical malpractice and leaving afternoon patients with low quality care that may not meet their medical needs.

A doctor’s caseload and decision fatigue

In recent years, it has become a well-known fact that doctors are over-worked and under-rested. On average, doctors work almost 60 hours a week. Now, if we break down what comprises such a workweek, we can begin to see how the medical profession is slated to deliver poorer quality of care as a workday goes on. A substantial part of a doctor’s day falls to decision-making. Everyone makes decisions throughout the day, but deciding what to eat for lunch is a far cry from the high stakes choices made by medical practitioners. They have to determine the best medicine to prescribe a patient, study whether another patient’s symptoms warrant a cancer screening, deliberate new treatment options for a patient with high blood pressure, and so forth. Making continuous mentally taxing decisions throughout the day can lead to what psychologist call “decision fatigue.”

Decision fatigue is a particular type of physical and mental weariness that arises out of repeated decision making, eventually culminating in a decreased ability to engage in demanding thought processes. When this happens, we typically make choices based on whichever option is easiest, i.e. whichever requires the least amount of mental effort. A recent study published in Health Economics describes this as a kind of decision‐making heuristic, “mental shortcuts that allow us to make decisions on the basis of simple rules of thumb without engaging in cognitively demanding reasoning. For those in health care, this starts to happen in the afternoon, following hours of continuous medical decision making.

Impact on health care

So how does decision fatigue play out when you’re a medical professional deliberating choices that could have major repercussions for your patients’ health? The Health Economics study mentioned earlier focused on orthopedic surgery and illustrated a downward trend in scheduling surgeries over the course of a workday. About 40.2% of patients in the study who were seen in the morning or just after lunch were scheduled for surgery by their doctor. However, towards the afternoon this percentage was cut to 21.7% and by the end of the day, the number of patients scheduled for orthopedic surgery dwindled to 6.7%. Other studies have pointed to a similar trend when it comes to ordering breast and colon cancer screenings as well as influenza vaccinations.

These are not comforting statistics coming from a profession whose foremost promise is to do no harm. Nevertheless, the reality is that doctors do face decision fatigue and in coping with low mental energy at the end of the day, they default to selecting medical options that are fast and easy. Under this current system, it seems that afternoon doctor visits are doomed to yield, at best, less than optimal care for patients and at worst, medical errors and incidents of malpractice. With patients’ health care at stake, there’s no question that insurance and health administrators need to find an improved way to approach the medical workday. However, such changes come slowly if they come at all.

What you can do

In the meantime, patients must take up a proactive role in their health care if they wish to avoid receiving rushed or inadequate medical service at the hands of exhausted doctors. A starting point may be steering clear of afternoon doctor visits. Although it may be difficult to arrange because of work and other commitments, try to schedule your appointments earlier in the day or request that you be notified if an earlier appointment becomes available. Of course, this is not always possible. If you find yourself with an afternoon appointment, the best thing you can do is prepare. Some patients may feel a little intimidated when speaking to a doctor, but go in knowing what your primary concerns are and write them down if needed. Another course of action in safeguarding your health care is seeking a second opinion. If you are doubtful or have concerns about your doctor’s diagnosis and treatment plan for you, reach out to another medical professional for their input.

It is important to keep in mind that if a medical error occurs and results in an injury to you or a loved one, you may qualify for a medical malpractice claim. Should you find yourself in this situation, get in touch with one of our medical malpractice attorneys at Novo Law Firm PC for a consultation.



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