Dr. Chad R. Brown, DVM (Purdue), executive director of the Lloyd Veterinary Medical Center at Iowa State University, joins Dr. Andy Roark to tackle a gut-punch truth in veterinary medicine: good decisions do not always equal good outcomes, and outcome-based judgment can be brutal on clinicians. They unpack how hindsight bias and outcome bias trick us into “judging our past self with our future self’s information,” rewarding lucky medicine and fueling shame after tough cases. Chad argues for de-emphasizing outcomes and emphasizing decision-making processes we can control, like communication, diagnostics, anesthesia monitoring, and checklists, especially when training students, interns, and residents. They also discuss how outcome fixation can break good clinicians through overcorrection or apathy, and how focusing on process can reduce burnout and support spectrum-of-care thinking.
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