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DDx Episode 2

Anchoring bias and the frequent flyer

10 minutes


Gita Pensa, M.D., FAAEM

Dr. Gita Pensa is a Clinical Assistant Professor of Emergency Medicine with the Brown Emergency Medicine Residency Program. She has an interest in digital medical education and is the editor of the Brown Emergency Medicine blog, as well as the Associate Director - Education of Brown’s Emergency Digital Health Initiative (EDHI). She is the lead podcaster for the Academic Emergency Medicine journal, and editor of the AEM Early Access podcast. Find her on Twitter at @GitaPensaMD. See more cases from the Brown Emergency Medicine Residency Program on Figure 1 at @BrownEM.

Marjorie P. Stiegler, M.D.

Dr. Stiegler is a Harvard-trained physician specializing in anesthesiology. Since 2005, her academic focus for research, writing, and speaking has been the application of behavioral psychology to patient safety in medical settings. She has given over 100 presentations across the globe on the role of cognitive bias in medical decision making, expertise, and error. Her publications can be found here. Dr. Stiegler also has a professional blog and can be followed on Facebook and Twitter at @drmstiegler. Her book “Quality and Safety in Anesthesia and Perioperative Care is available on Amazon.


A 19-year-old female with sickle cell disease presents to the emergency department in acute pain that she describes as most severe in her legs and back and radiating to her abdomen. A frequent visitor to the ER with painful crises, the patient is convinced this is just another episode, and emergency medicine physician Dr. Gita Pensa treats her accordingly. When the pain worsens, Dr. Pensa questions her original diagnosis, and realizes the one crucial bias that nearly blinded her from correctly diagnosing the patient.