There are several common misconceptions that influence health. For instance, diseases with a very gradual onset typically seem relatively new (1). As symptoms begin to arise, patients may mistake the disease for an acute event or an injury. 

Patients vary in their understanding of health issues. One important aspect of health literacy is understanding that the human mind is prone to biases (misconceptions). Under certain circumstances, faulty intuition can lead patients to make decisions that are not in their best interest. Reliance on informal social networks and their experiences with other unrelated conditions can contribute to or reinforce faulty reasoning. 

On the other hand, not taking patient intuition seriously can violate patient dignity, so physicians should consider the credibility and personal significance behind every patient concern in order to improve the patient-clinician relationship, as well as health outcomes. An effective relationship helps gently and incrementally correct common misconceptions. It’s important that patients make choices about their health that are based on accurate information and on their values (what matters most to them).  

There is evidence that  people with more symptoms and limitations (which tends to reflect greater distress) may be more likely to choose invasive treatments (2), at a time when treatment of the distress might take priority. 

More adaptive patients are less likely to choose injection or surgery, regardless of disease severity. Psychosocial factors correlated with greater symptoms and limitations lead patients to feel as if they have less treatment options. In other words, physicians not paying attention to certain psychosocial factors may increase the risk of misunderstanding of patient preferences.   

Our research on faulty intuition is focusing on several areas:

1. We are studying the psychological and sociological factors associated with higher healthcare seeking behavior.
2. Our future qualitative studies will assess depression, anxiety, and coping strategies of patients in recovery, as well as the decision-making regarding the provision of emotional support and psychologic therapies after surgery.
3. We are promoting effective communication strategies so that age-related diseases are not perceived as an injury as they progressively transition from asymptomatic to symptomatic. Rather than making choices based on misconceptions, this will allow patients to choose treatment that is consistent with their values. 
4. The use of medical jargon is being considered as a risk for the misdiagnosis of patient preferences and reinforces common misconceptions rather than values.
5. We are investigating how doctor rating sites and polarized reviews affect the perceived credibility of a physician and how they affect patient decision-making.
6. We are classifying the cognitive errors and biases in current treatment of common hand and upper extremity problems.

References

1. van Hoorn BT, Wilkens SC, Ring D. Gradual Onset Diseases: Misperception of Disease Onset. J Hand Surg Am. 2017 Sep 9. pii: S0363-5023(17)31272-8. doi:10.1016/j.jhsa.2017.07.021. [Epub ahead of print] PubMed PMID: 28899587.
2. Wilkens SC, Menendez ME, Ring D, Chen N. QuickDASH Score Is Associated With Treatment Choice in Patients With Trapeziometacarpal Arthrosis. Hand (N Y). 2017 Sep;12(5):461-466. doi: 10.1177/1558944716677937. Epub 2016 Nov 9. PubMed PMID:28832210.