ClickCare Café

Doctors Get Worse at Diagnosis Over Time - But You Don't Have To

Posted by Lawrence Kerr on Wed, Jun 01, 2016 @ 07:30 AM


The great podcast Freakonomics has been doing some powerful episodes recently, as part of their "self improvement month."

One episode seemed particularly relevant to the ways that the ClickCare community does healthcare collaboration and why it makes such a dramatic difference in healthcare as a whole.

First, let me back up.

K. Anders Ericsson is a professor of psychology at Florida State University. He has studies how people become world-class at anything from surgery to music to sports.

And it turns out that, for the most part, human beings are getting better and better at learning how to learn. For instance, in order to qualify to run the Boston Marathon today, a male in the 18- to 34-year-old group has to have a time of 3 hours and 5 minutes. That time is only 6 minutes slower than the WINNER of the marathon in the 1896 olympics.

Ericsson says that "we’ve gotten so much better primarily because we’ve learned how to learn." And he links this ability to learn things to something he calls "deliberate practice." Not just logging hours, but practice involving "well-defined, specific goals, and [it] often involves improving some aspect of the target performance. It is not aimed at some vague, overall improvement.”

Interestingly, Ericsson cites studies that show that for doctors, their ability to diagnose heart sounds actually decreases the longer they are in practice. He says that this is because most physicians are in a fairly isolated environment, and that because they don't have coaching, input, challenge, support, or feedback during the diagnosis process -- they don't get better. In other words, doctors practice, but it's not deliberate practice, so they don't improve.

“Once a person reaches that level of “acceptable performance and automaticity,” Ericcson writes, "the additional years of 'practice' don’t lead to improvement.”

This data resonates with us because we see such significant gains in patient results, decrease in readmissions, decrease in length of stay, and even a drop in provider burnout when healthcare providers use a telemedicine tool for healthcare collaboration.

A few reasons why telemedicine-based healthcare collaboration can have such dramatic results:

  • Providers get immediate feedback, to support improvement. 
    When I get the relief of asking another provider for her consult on a case, I'm not just helping make my day easier and improving care for that patient -- I'm also getting what amounts to targeted coaching and feedback on my diagnosis and care overall -- a key component of "deliberate practic." 
  • Cases are saved for teaching. 
    One key difference between videoconferencing and hybrid store-and-forward telemedicine is that with something like iClickCare, all cases are saved and searchable so that you can use them to learn from and teach with in the future. That means immediate gains for you and your patients, plus effortless long-term building for the future.
  • This kind of collaboration adapts to providers' real lives and real tools. 
    We always tell people that they can do healthcare collaboration however they want, but never to invest in huge hardware infrastructure that is going to go obsolete fast, as well as be a huge learning curve and workflow conundrum for the people using it. For practice to be significant in terms of improving results, it needs to integrate flawlessly into providers' lives and use tools they already have.
  • Healthcare collaboration and care coordination go hand in hand. 
    Healthcare collaboration is usually seen as the one-off "conversation" about the patient. But when you can have mutliple providers -- across the continuum of care -- collaborating on cases, that means it's not just collaboration that's happening -- it's meaningful care coordination. 


The one thing that differentiates people who use iClickCare from those who don't isn't tech savvy or background. It is simply the sincere desire to have more fun while they do medicine, and to care for each patient as well as they possibly can.

When deliberate practice is part of the equation, using simple tools, it's not hard to see why they succeed so well at those goals.


Learn more about what makes hybrid store-and-forward telemedicine different here: 


ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: medical collaboration, hybrid store and forward medical collaboration, provider burnout, healthcare collaboration, decrease readmissions, decrease length of stay

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