“The emotional temperature of the doctor plays a substantial part in diagnostic failure and success”

Am J Emerg Med. 2014 Feb 14. pii: S0735-6757(14)00098-9. doi: 10.1016/j.ajem.2014.02.007. [Epub ahead of print]

The hateful physician: the role of affect bias in the care of the psychiatric patient in the ED.

Park DB1, Berkwitt AK2, Tuuri RE3, Russell WS3.

Author information

• 1Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA. Electronic address: dpark419@gmail.com.
• 2Department of Pediatrics, Yale-New Haven Children's Hospital, New Haven, CT, USA.
• 3Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA.

"In busy emergency departments (EDs) with filled waiting rooms and exploding numbers of psychiatric boarders, patients with behavioral or psychiatric complaints may fall prey to affect biases of clinicians, preventing the delivery of quality patient care and potentially the diagnosis of underlying medical illness [8]. In a review of “How Doctors Think”, Horton writes: “The emotional temperature of the doctor plays a substantial part in diagnostic failure and success” [9]. Patients with psychiatric complaints often visit the ED and frequently display stereotypical presentations that have the potential to generate strong, negative emotional states in clinicians that affect how care is provided. If clinicians are not aware of these feelings, they are liable to provide substandard care secondary to an aversion for the patient."