[throwbmw]

Excellent article. Practicing anesthesiologist of 25 years. Agree 100 percent with the problems highlighted in the article. These problems are increasing day by day with increasing algorithmization and protocolization of everything. So as the article mentions , there are two many individual variations and edge cases in day to day practice of medicine. An experienced doctor will have a a pretty good idea if following a protocol blindly can harm a patient but if they act on their experience and deviate from protocol they are open to liability even if the outcome was good. But I don't believe humanities education us the answer to this problem. It needs a system wide reset.

[firejake308]

What's wrong with the simple solution, i.e., understanding when the algorithms apply and when they don't? For example, if an RCT shows that in-hospital initiation of all 4 of the heart failure GDMT's leads to reduced mortality compared to delayed initiation of GDMT, then you also have to learn that 97% of patients in the study had a baseline SBP of at least 97. Therefore, maybe you shouldn't start 4 BP-lowering meds on your HF patient with a baseline SBP of 86. If people learn when to apply rules, then I think you don't need humanities education and you don't need a system-wide reset either.

[acheron]

The issue isn’t the doctor knowing when to use the algorithm and when to deviate, but explaining that deviating from the algorithm was the right choice to the judge and jury in the subsequent lawsuit.