Explore the Pomegranate Health Podcast library
Browse all episodes below, starting with the most recent releases.
Latest episodes
Ep34: Diagnostic Error Part 2—Systems
In Episode 32 of Pomegranate Health, we discussed cognitive error in diagnostic reasoning. On this episode, we take a look at systems pressures that increase the likelihood of medical error, crystallised by the recent prosecution of U.K. National Health Service (NHS) paediatrician Dr Hadiza Bawa-Garba. Almost half of diagnostic errors are due to a combination of systems errors and individual cognitive error. Obvious systems effects come into play in understaffed acute care units; if a clinician is forced to see too many patients without enough time to make careful examinations or reasoned decisions, errors become more likely. The stepping stones of ordering, receiving and reviewing diagnostic tests and scans also allow much opportunity for error and delay. Guests on this episode discuss mechanisms to improve efficiency.
Ep32: Diagnostic Error Part 1—Cognitive Bias
This is the first of two episodes about errors in diagnostic reasoning. Misdiagnosis or delayed diagnosis occurs in 10-15 per cent of acute presentations, although fortunately only a tenth of these lead to serious consequences. But of concern is the fact that this figure hasn’t changed in three decades, despite progress in clinical knowledge. Cognitive errors result from jumping to conclusions on the basis of intuition and incomplete information. There are a hundred different types of such bias. On this episode, the most common types will be discussed, as well as strategies to force a more considered process of diagnostic reasoning.
Ep26: Dealing with Uncertainty – Part 2
Uncertainty is a frightening but unavoidable fact in every speciality. In the second of a two-part series, we look at the stigma and disorientation experienced by patients with medically unexplained syndromes, and some behavioural interventions for functional disorders. Since treatment outcomes are never guaranteed, we also discuss how a patient’s expectations must be managed from the beginning of a consultation, and the importance of long-term coping strategies.
Ep25: Dealing with Uncertainty – Part 1
Uncertainty is a frightening but unavoidable fact in every speciality. In the first of a two-part series, we examine the culture within the profession and general public that expects nothing less that perfection in medicine. We also ask whether hospital training might shelter younger doctors from the experience of complex, chronic conditions, and how much the simplicity of protocol can be relied upon.
Ep3: Law at End-of-Life
Doctors may have gaps in their knowledge of end-of-life law. In this episode, the last of our end-of-life series, we review the relevant legal frameworks.
Ep2: Cultural Humility
Treating a dying person goes beyond understanding their disease. In the second of a three-part series, we examine the importance of family and culture in end-of-life care—from the ICU to the neonatal unit.
Ep1: Recognising Death
For our first show we're starting at the end: end-of-life care and decision-making. It's a hard topic to discuss with patients, but it might be the most important conversation we're not having.