Table 1

Common cognitive illusions

Emotionally reasoningJumping to incorrect conclusions based on your feelingsI feel like a bad doctor [“therefore” I am a bad doctor]I feel angry [“therefore” this resident must be up to something]
Fortune tellingPresuming to know the futureI just know I’ll never master the brachial plexusThis resident’s destined to raise the world’s malpractice fees
Mind readingPresuming to know what someone else is thinkingI just know my call partner is mad at me [he’s actually just exhausted]This resident thinks I’m an idiot [she’s actually just intimidated]
OvergeneralizingOvergeneralizing from the facts at handI didn’t get the preceptor I wanted—my career is ruined!I missed that coccidioidomycosis — I belong in Doctor Jail
PersonalizingTaking things too personallyThat memo was targeted at me! [his charts are actually more current than average]That resident is very uncooperative [she’s actually worried sick about her mother’s cancer]
PolarizingSeeing things too absolutely (all-or-nothing, black-or-white)Either I get into ophthalmology or my lifestyle spouse will leave meThis kid’s either gonna be an Osler or a Shipman
ShouldingExcessive self-criticism (sometimes introducing morality when none is warranted)I should be as sharp after 36 hours on call as after a surfing vacation in HawaiiI must make all the applause-worthy diagnoses