Sometimes a Snapple cap can change everything. I opened my iced tea, flipped the lid as I always do, and stopped in my tracks. “You are always looking at your nose, your brain just chooses to ignore it.” That can’t be true. I couldn’t be spending my life just ignoring something as obvious as, well, the nose on my face. If that is true, what else am I missing?

This is a question we expect our healthcare providers to ask themselves. What am I missing? But when it comes to provider/patient relationships, we all have to be aware that we may be missing something. Providers and patients alike have the curse of knowledge, and that can be deadly to the relationship and to the patient. But there are ways to handle the curse.

The curse of knowledge is a cognitive bias that says once you know something, you can’t imagine not knowing it. You don’t see what other people see– just as you don’t see your nose because you know it so well. For doctors, that means they may not realize their patient has no idea what an MRI is, or what metastasized means. That curse of knowledge can cause damage to the provider/patient relationship. Patients don’t want to appear dumb, so they don’t ask questions. Doctors have the curse of knowledge, so they don’t give explanations. At best, there is no meeting of the minds and hearts. At worst, the lack of understanding leads to complications and lawsuits.

Patients have the curse of knowledge as well. We live in our bodies every day. I saw the curse of knowledge first hand when I started experiencing pain in my right pinky finger. The joint was very swollen, the finger looked bent and it hurt. I went to two doctors who told me it could be arthritis and ordered an x-ray. I took out my phone to look up x-ray centers, and noted that the phone and its extra battery I had attached was resting right on my pinky joint. The deformation in my pinky was right where my phone rested. I googled it, and it turns out lots of people have deformed pinky fingers because of their phones. I didn’t think to tell my doctors that I used the phone for WAY too many hours a day, that I had a battery that doubled the weight of my phone, and that I rested the phone right on that joint. I knew all of that so well that I couldn’t imagine the doctor wouldn’t know as well. When a patient has the curse of knowledge, it, too, can lead to complications and lawsuits.

I often say “you don’t know what you don’t know”. At the same time, we often assume others know what we know, and we are wrong. If 17.3 million Americans think chocolate milk comes from brown cows, it’s fair to see we shouldn’t assume everyone knows what metastasize means, or that I use my phone way too much.

There is a way to dispel the curse of knowledge. Communicate.  Ask questions, offer explanations, watch body language, and don’t be afraid to sound stupid.  This applies to providers and patients alike. We can all get smarter–one Snapple cap at a time.

8 thoughts on “Are Patients and Doctors Cursed?

    1. Well that made my day! trying to get a doctor/patient blog out once a week, plus the daily challenges, has me thinking too much and feeling like a pest! Glad you liked that one Ron.

  1. Don’t tell anyone, (shhhh), but when I get an MRI or something really, really important, come close, I’m whispering, (shhhh(, I go to the records room of the hospital (shhhhh, is anyone listening to us) the following day and get my report even before the doctor calls me. I’ve already read, researched and digested the report before he/she called me, sitting there (shhhh) talking it all in and learning all the more I can from my doctor perspective, expertise and what I can from his/her interpretation of the same report. Call it nosy, proactive, OCD or whatever, but I just can’t wait and I guts to know.

    1. Smart–gives you time to process it all. This is why I’m a HUGE proponent of Open Notes. Not everyone can get their records that easily…

  2. I don’t think knowledge is the curse. I think arrogance is. Knowledge + arrogance =very poor communication. Patients also come in with the combination of knowledge from Dr. Google, they can be immovable from their positions, and what the doctor has to do is become VULNERABLE. Feel what it is like for them to have searched for so long, albeit a very sketchy data base, in desperation for answers, an attempt to bring them back to a normal life. From compassion and vulnerability, they will slowly move off of their positions if inaccurate, and an opening appears in which true relationship and communication can occur. Patients become defensive, often misinformed, and heels dug in, because they are not listened to. I live this every day.

    1. More doctors have to open themselves up to being vulnerable–it’s hard for all of us, and I’d imagine worse so if you are in a profession that traditionally doesn’t value vulnerability. Both dr and patient have to be willing to learn from each other. You don’t know what you don’t know…..

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