Common Physician Thought Distortions, Overgeneralization

We continue to look at common thought distortions affecting the entire population that do not spare us as a physician community. And some seem to be more prevalent for us.

Overgeneralization is when we take one negative outcome and stretch it to mean everything with similarities. It’s the cognitive equivalent of an underpowered study where the sample size is too small, but the authors still draw sweeping conclusions to the whole population. You can often spot it by absolute words like all, none, always, or never (and sometimes sneakier words like "they").

These broad strokes may feel convincing in the moment, but they create a cycle of discouragement and defeat.

Examples in medicine?

• You rotate through a private practice with front–back office conflict and decide: I’ll never work in private practice. They’re all toxic.

• You get constructive feedback on a talk and think: I’m never going to get the hang of academic medicine.

• A urologist cuts you off mid-sentence on call, tells you “this doesn’t require a surgical consult,” and hangs up. The thought spiral? All urologists are jerks.

Now, I’m not picking on urologists. I know many who are outstanding collaborators and colleagues. The example is about how our brains can take one frustrating encounter and expand it into a whole stereotype. And while humor about specialty personalities (hello, Dr. Glaucomfleken) can be fun, when it seeps into reflex reactions, it becomes a problem.

The consequences: overgeneralization fuels anxiety, erodes confidence, and can affect team dynamics and patient care. Maybe you avoid an important consult next time, or pass your negative bias on to a learner.

What helps?

• Ask: What are five other possibilities? (Maybe it was an unusual day, a one-off dynamic, or someone working on zero sleep.)

• Flip the script: focus on positive feedback or times things did go well.

• Use ladder thoughts: move one step up from the bottom rung (“All urologists are hostile”) to something slightly more open (“I'm open to believeing they're not all this way.” or even more generous grace, "I'm open to believing they're just having a terrible day and are behind on sleep."). With practice, you climb rung by rung until the distortion loosens its grip.

Another place this distortion hides is in the word they. They don’t think I’m competent. They always expect too much. They’ll think I'm crazy. But who exactly are they? Often there’s no face, just a vague cloud of assumptions. By naming who truly matters, and whose voice deserves weight, we stop handing power to an undefined “they” and start discerning which opinions actually help us grow.

Bottom line: Every one of us has cognitive distortions we fall back on, especially when tired, stressed, or stretched. Spotting overgeneralization is the first step. From there, challenge the absolute words, look for nuance, and practice more balanced thoughts.

Okay, I hope this has been a helpful series. I'll see you next week in our new series.

Have a joy-filled week! Tonya