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September 15, 2010

How (Should) Physicians Think?A Journey From Behavioral Economics to the Bedside

Author Affiliations

Author Affiliations: Division of Clinical Decision Making, Informatics and Telemedicine, Department of Medicine, Tufts Medical Center, Boston, Massachusetts.

JAMA. 2010;304(11):1233-1235. doi:10.1001/jama.2010.1336

Following the path forged a half century ago by psychologist Ward Edwards1 and economists John von Neumann and Oskar Morgenstern,2 academicians have proffered descriptive observations and prescriptive theories concerning decision making under uncertainty.3,4 Edwards and his intellectual progeny spawned the field of behavioral decision theory, which identified cognitive limitations and foibles described today, even in the lay literature.5,6 Led by Edwards' disciples Ledley and Lusted7 and later by Elstein8 and Kassirer et al,9 psychologists, decision theorists, and clinicians have explored and expounded on clinical reasoning by physicians, who are subject to all-too-human cognitive limitations and biases when formulating diagnostic hypotheses and making therapeutic choices.

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