Skip to main content

Advertisement

Log in

When Should Patient Intuition be Taken Seriously?

  • Perspectives
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

As a style of information processing, intuition involves implicit perceptual and cognitive processes that can be quickly and automatically executed without conscious mental will, such that people know more than they can describe. Patient intuition can influence patient and clinician decision-making and behavior. However, physicians may not always see patient intuition as credible or important, and its management in the clinical setting is poorly understood. This paper takes a step toward suggesting conditions under which patient intuition should be taken seriously. These conditions relate to the credibility or accuracy of the intuitive beliefs held by the patient, and their significance to the patient. Credibility may be increased when the intuitions of patients (1) reflect their individualized knowledge, (2) can complement the common absence of scientific evidence in managing health problems, and (3) can quickly and effectively process key information in complex cognitive tasks. Even intuitions that lack credibility can be subjectively rational and meaningful to patients, and help to shape the decisions they and clinicians make.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Isenman L. Toward an understanding of intuition and its importance in scientific endeavour. Persp Biol Med. 1997;40(3):395–403.

    Google Scholar 

  2. Evans J. Dual-processing accounts of reasoning, judgment and social cognition. Ann Rev Psychol. 2008;59:255–78.

    Article  Google Scholar 

  3. Polanyi M. The tacit dimension. Garden City, New York: Doubleday; 1967.

    Google Scholar 

  4. Hall E, Cooper A, Watter S, Humphreys K. The role of differential diagnoses in self-triage decision-making. Appl Psychol: Health Well-Being. 2010;2(1):35–51.

    Article  Google Scholar 

  5. Zhenhua Y. Tacit knowledge/knowing and the problem of articulation. Tradition & Discovery. Polanyi Soc Period. 2003-4;30(2):11–23.

    Google Scholar 

  6. Klein G. Intuition at work. New York: Bantem Dell; 2003.

    Google Scholar 

  7. Butchel E, Norenzayan A. Which should you use, intuition or logic? Cultural differences in injunctive norms about reasoning. Asian J Soc Psychol. 2008;11(4):264–73.

    Article  Google Scholar 

  8. Redelmeier DA, Schull MJ, Hux JE, Tu JV, Ferris LE. Problems for clinical judgment: 1. Eliciting an insightful history of present illness. Can Med Assoc J. 2001;164(5):647–51.

    CAS  Google Scholar 

  9. Hall K. Reviewing intuitive decision-making and uncertainty: the implications for medical education. Med Educ. 2002;36(3):216–24.

    Article  PubMed  Google Scholar 

  10. Haynes R, Devereaux P, Guyatt G. Clinical expertise in the era of evidence-based medicine and patient choice. ACP J Club. 2002;136:A11–4.

    Google Scholar 

  11. Henry S. Recognising tacit knowledge in medical epistemology. Theor Med Bioeth. 2006;27(3):187–213.

    Article  PubMed  Google Scholar 

  12. Tracey C, Dantas G, Upshur R. Evidence-based medicine in primary care: qualitative study of family physicians. BMC Fam Pract. 2003;4(6). Accessed on October 26, 2010 at: http://www.biomedcentral.com/1471-2296/4/6.

  13. Groopman J. Second Opinions. Stories of Intuition and Choice in the Changing World of Medicine. New York: Penguin; 2000.

    Google Scholar 

  14. Chandra A, Lindsell C, Limkakeng A, et al. Emergency physician high pretest probability for acute coronary syndrome correlates with adverse cardiovascular outcomes. Acad Emerg Med. 2009;16(8):740–8.

    Article  PubMed  Google Scholar 

  15. King L, Appleton J. Intuition: a critical review of the research and rhetoric. J Adv Nurs. 1997;26(1):194–202.

    Article  PubMed  CAS  Google Scholar 

  16. Magin P, Adams J, Joy E, Ireland M, Heaney S, Darab S. General practitioners' assessment of risk of violence in their practice: results from a qualitative study. J Eval Clin Pract. 2008;14(3):385–90.

    Article  PubMed  Google Scholar 

  17. Broadbent E. Illness perceptions and health: Innovations and clinical applications. Soc Pers Psychol Compass. 2010;4(4):256–66.

    Article  Google Scholar 

  18. Norman G, Eva K. Diagnostic error and clinical reasoning. Med Educ. 2010;44(1):94–100.

    Article  PubMed  Google Scholar 

  19. Gilovich T, Griffin D, Kahneman D, eds. Heuristics and Biases: The Psychology of Intuitive Judgment. Cambridge: Cambridge University Press; 2002.

    Google Scholar 

  20. Pescosolido B. Beyond rational choice: the social dynamics of how people seek help. Am J Sociol. 1992;97(4):1096–138.

    Article  Google Scholar 

  21. Lieberman M. Intuition: A social cognitive neuroscience approach. Psychol Bull. 2000;126(1):109–37.

    Article  PubMed  CAS  Google Scholar 

  22. Sinclair M, Ashkanasy N. Intuition: Myth or a decision making tool? Manag Learning. 2005;36(3):353–70.

    Article  Google Scholar 

  23. Lieberman M. Social cognitive neuroscience: A review of core processes. Ann Rev Psychol. 2007;58:259–89.

    Article  Google Scholar 

  24. Greenhalgh T. Intuition and evidence—uneasy bedfellows? Br J Gen Pract. 2002;52(478):395–400.

    PubMed  Google Scholar 

  25. Dane E, Pratt M. Exploring intuition and its role in managerial decision making. Acad Manag Rev. 2007;32(1):33–54.

    Google Scholar 

  26. Hogarth R. Educating Intuition. Chicago: University of Chicago Press; 2001.

    Google Scholar 

  27. Molina M, Isoardi R, Prado M, Bentolila S. Basal cerebral glucose distribution in long-term post-traumatic stress disorder. World J Biol Psychiat. 2010;11:493–501.

    Article  Google Scholar 

  28. Dorfman J, Shames V, Kihlstrom J. Intuition, incubation, and insight: Implicit cognition in problem solving. In: Underwood G, ed. Implicit cognition. Oxford University Press; 1996.

  29. Jones D, Gill P. Refugees and primary care: tackling the inequalities. BMJ. 1998;317(7170):1444–6.

    PubMed  CAS  Google Scholar 

  30. Buetow S. Something in nothing: Negative space in the clinician-patient relationship. Ann Fam Med. 2009;7(1):80–3.

    Article  PubMed  Google Scholar 

  31. Norman G, Young M, Brooks L. Non-analytical models of clinical reasoning: the role of experience. Med Educ. 2007;41(12):1140–5.

    PubMed  Google Scholar 

  32. Ellis J, Mulligan I, Rowe J, Sackett DL. Inpatient general medicine is evidence based. Lancet. 1995;346(8972):407–9.

    Article  PubMed  CAS  Google Scholar 

  33. Gill P, Dowell A, Neal R, Smith N, Heywood P, Wilson A. Evidence based general practice: a retrospective study of interventions in one training practice. BMJ. 1996;312(7034):819–21.

    PubMed  CAS  Google Scholar 

  34. Kahneman D, Klein G. Conditions for intuitive expertise: a failure to disagree. Am Psychol. 2009;64(6):515–26.

    Article  PubMed  Google Scholar 

  35. Upshur REG. Seven characteristics of medical evidence. J Eval Clin Pract. 2000;6(2):93–7.

    Article  PubMed  CAS  Google Scholar 

  36. Ioannidis J. Why most published research findings are false. PLoS Med. 2005;2(8): e124. Accessed on October 26, 2010 at: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020124.

  37. Straus S. Individualizing treatment decisions. Eval Health Profess. 2002;25(2):210–24.

    Google Scholar 

  38. Boudon R. The ‘Cognitivist Model’: A Generalized ‘Rational-choice model’. Rational Soc. 1996;8(2):125–50.

    Google Scholar 

  39. Leventhal H, Meyer D, Nerenz D. The common sense representation of illness danger. In: Rachman S, ed. Med Psychol. New York: Pergamon; 1980:7–30.

    Google Scholar 

  40. Redelmeier D, Rozin P, Kahneman D. Understanding patients’ decisions. Cognitive and emotional perspectives. JAMA. 1993;270(1):72–6.

    Article  PubMed  CAS  Google Scholar 

  41. Wright E. On intuitional stability: The clear, the strong, and the paradigmatic. Cognition. 2010;115(3):491–503.

    Article  PubMed  Google Scholar 

  42. Buetow S, Henshaw J, Bryant L, O’Sullivan D. Medication timing errors for Parkinson’s Disease: Perspectives held by caregivers and people with Parkinson’s in New Zealand. Park Dis. 2010. Accessed on October 26, 2010 at: http://downloads.sage-hindawi.com/journals/pd/2010/432983.pdf.

  43. Segalowitz S. Knowing before we know: Conscious versus preconscious top-down processing and a neuroscience of intuition. Brain Cognition. 2007;65(2):143–4.

    Article  CAS  Google Scholar 

  44. James W. What is an emotion? Mind. 1884;9(34):188–205.

    Article  Google Scholar 

  45. Thayer J, Brosschot J. Psychosomatics and psychopathology: looking up and down from the brain. Psychoneuroendocrinology. 2005;30(10):1050–8.

    Article  PubMed  Google Scholar 

  46. Brosschot J, Gerin W, Thayer J. The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. J Psychosom Res. 2006;60(2):113–24.

    Article  PubMed  Google Scholar 

  47. Broadbent E, Ellis C, Thomas J, Gamble G, Petrie K. Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial. J Psychosom Res. 2009;67(1):17–23.

    Article  PubMed  Google Scholar 

Download references

Financial disclosure

None.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephen A. Buetow PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Buetow, S.A., Mintoft, B. When Should Patient Intuition be Taken Seriously?. J GEN INTERN MED 26, 433–436 (2011). https://doi.org/10.1007/s11606-010-1576-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-010-1576-6

KEY WORDS

Navigation