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. 2022 Aug 22;10(1):4-8.
doi: 10.1515/dx-2022-0058. eCollection 2023 Feb 1.

Improving diagnosis: adding context to cognition

Mark Linzer  1 , Erin E Sullivan  2   3 , Andrew P J Olson  4 , Maram Khazen  2   5   6 , Maria Mirica  5 , Gordon D Schiff  2   5
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Free article

Improving diagnosis: adding context to cognition

Mark Linzer et al. Diagnosis (Berl). .
Free article

Abstract

Background: The environment in which clinicians provide care and think about their patients is a crucial and undervalued component of the diagnostic process.

Content: In this paper, we propose a new conceptual model that links work conditions to clinician responses such as stress and burnout, which in turn impacts the quality of the diagnostic process and finally patient diagnostic outcomes. The mechanism for these interactions critically depends on the relationship between working memory (WM) and long-term memory (LTM), and ways WM and LTM interactions are affected by working conditions.

Summary: We propose a conceptual model to guide interventions to improve work conditions, clinician reactions and ultimately diagnostic process, accuracy and outcomes.

Outlook: Improving diagnosis can be accomplished if we are able to understand, measure and increase our knowledge of the context of care.

Keywords: diagnosis; physician burnout; work conditions.

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References

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    1. Schiano, B. Reducing cognitive overload while teaching . Harvard Business Publishing. Available from: https://hbsp.harvard.edu/inspiring-minds/reducing-cognitive-overload-whi... .
    1. Linzer, M, Manwell, LB, Williams, ES, Bobula, JA, Brown, RL, Varkey, AB, et al.. Working conditions in primary care: physician reactions and care quality. Ann Intern Med 2009;151:28–36. https://doi.org/10.7326/0003-4819-151-1-200907070-00006 . - DOI
    1. Linzer, M, Gerrity, M, Douglas, J, McMurray, JE, Williams, ES, Konrad, TR. Physician stress: results from the physician worklife study. Stress Health 2002;18:37–42. https://doi.org/10.1002/smi.917 . - DOI
    1. Croskerry, P. The rational diagnostician and achieving diagnostic excellence. JAMA 2022;327:317–8. https://doi.org/10.1001/jama.2021.24988 . - DOI

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