How Doctors Think
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How Doctors Think

3.83 of 5 stars 3.83  ·  rating details  ·  5,557 ratings  ·  583 reviews
On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong -- with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces a...more
Hardcover, 320 pages
Published March 19th 2007 by Houghton Mifflin Harcourt
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Community Reviews

(showing 1-30 of 3,000)
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Kirsti
Things that you should find worrisome if a doctor says them to you or a loved one:

* "We see this sometimes" when said about a case that has some atypical features. The doctor is basically telling you that s/he has stopped thinking.

* "There's nothing wrong with you." Even if your problems are psychogenic, they're still problems, and you are still suffering.

Things you can say to your doctor to help him/her with your case:

- "What's the worst this could be?"

- "Is it possible that I have more than on...more
Alison
Jan 04, 2009 Alison rated it 5 of 5 stars
Recommends it for: medical students, patients, physicians
How Doctors Think by Jerome Groopman, is a book that explores the topic of the manner by which physicians are taught to think, how they arrive at correct and incorrect diagnoses and how the personality of the physician, the patient and the interaction between the two can affect the diagnosis and treatment. The book is loosely laid out in the same manner that a physician works through a problem with a patient – the history, the physical exam, the lab tests, the differential diagnosis (which is al...more
Sue
Aug 02, 2008 Sue rated it 5 of 5 stars
Recommends it for: Every doctor, every potential patient
A must read for every doctor who practices medicine and for those patients who forget that doctors are practicing medicine and make errors in judgment (and he explains why these mistakes are made in a very very entertaining way). The book served as a reminder that a patient needs to be the captain of their own ship, challenging the inflated notion of even the most respected doctor... The chapter "A New Mother's Challenge" was probably one of the best examples of how and why doctors err and how t...more
Sarah
My book club read this book last month. We found it interesting, but repetitive. Basically, Dr. Groopman discusses many ways in which doctors are, gasp, not omniscient and in fact are susceptible to the same errors/ruts/gaps in thinking that plague any of us when trying to solve problems. Recognizing these fallibilities--understanding how a doctor is trained to think-- enables patients to be more proactive, to ask better questions, and thus help themselves by helping the doctor find the correct...more
Christine
The Science of Doctor Misdiagnosis -- Jerome Groopman is the chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston, teaches at Harvard Medical School and is a writer for the New Yorker. Groopman is a doctor who realizes he needs a doctor as the result of an experience in which he found himself plagued by a wrist injury that resulted in multiple diagnoses and treatments from four different doctors with no clear and rationale diagnosis. As a result, he decides to embark...more
Emma
Can Jerome Groopman be my doctor? Mentor? Inspiration? He is so thoughtful and humble and insightful! I am glad that as I go into medical school, I have read this book, and I think I may need to read it again to refresh my memory. Anyone can learn something from this book about how doctors think and how you as a patient can help them. (We have all had our frustrating moments with the medical system.) And I think all doctors (and aspiring doctors) should read this book.
Greg
This book helped me make decisions that gave me the patience to weather many tests and consultations that led to the discover of my coronary artery disease before I got a heart attack. Doctors are people too. They are trying to make a living and doing the best they can. Don't hate them because the prescribe expensive drugs or inconclusive tests. You need to work with them and force them to communicate their thinking. Always ask why a test is being administered. When a diagnosis is made, always a...more
Jack
First of all, I should say that I'm a doc.

This book was strongly recommended to me by several colleagues who I deeply respect. It makes for a reasonable read, and I see why they enjoy it.

It's pretty typical doctor-authored literature. It takes a half decent idea from the social sciences (in this case, that heuristic reasoning is essential for managing very complex environment, but that heuristics have predictable failings). It then illustrates this with a bunch of stories of touching stories of...more
Book Concierge
Book on CD read by Michael Prichard
3***

Groopman did a wealth of research and extensive interviews with some of America’s best doctors, as well as used his own experiences as a physician and as a patient, to craft this treatise on the thought processes behind the decisions made by physicians. He expounds on the cognitive pitfalls that might cause misguided care: premature closure, framing effect, search satisfaction. He also explores the tendency to rely on algorithms and statistical profiles rat...more
Pris robichaud

The Patient: Leader of the Healthcare Team, 1 April 2007



"Patients and their loved ones swim together with physicians in a sea of feelings. Each needs to keep an eye on a neutral shore where flags are planted to warn of perilous emotional currents". Jerome Groopman

The Patient: as a student nurse I was educated to understand that I always needed to listen to my patient, really listen. That philosophy has always served me well. Health care providers tend to be controlling, and when we are given a...more
P Chulhi
Groopman's free-flowing anecdotal style is his strength, and his unique perspective and journalistic skill are highlighted in the chapter entitled, "Marketing, Money, and Medical Decisions." Here he offers a nuanced perspective and a reasonable, if mundane solution. Medical decisions are indeed influenced by money, Groopman argues, but not in the way most of us might think with the bad guys dressed in black on one side and the good guys adorned in white on the other. Instead, medical decisions a...more
Emily
Everyone makes mistakes every day. We dial a wrong number, or accidentally put bleach in the washing machine with the jeans, or don't see the stop sign. Some mistakes have minor consequences; others can be life-changing. Physicians make dozens, if not hundreds, of decisions a day, many significantly affecting the health and life of others; but in spite of the stakes, it would be unrealistic to expect perfection on every single one. In How Doctors Think, Dr. Groopman investigates how physicians m...more
Sharon
An excellent account of circumstances and other factors that can influence how a physician processes information about symptoms a patient reports and clinical observations the doctor makes when determining a diagnosis and subsequent treatment.

The author also offers insights into how the business of running a medical practice collides with the practice of medicine. The reality of today's medical practice is that patients are time slots and your doctor is expected to come up with a diagnosis with...more
Sheri
This highly readable book by medical writer Jerome Groopman certainly explains why I usually leave my doctor's office feeling the way I do, which is not particularly happy, despite my overall good health.

Groopman opines that "good medicine" is practiced by doctors who get to know their patients, ask them open-ended questions that allow the patient to provide the clues needed to make an accurate diagnosis, and are good listeners. When there's a shortage of primary care physicians like we're expe...more
Di
I purchased this book as a result of the frustration I have been experiencing from my own present medical care. Since becoming chronically ill, I have yet to receive a definitive diagnosis, despite the fact that I have seen numerous doctors. Also, upon reviewing my medical records I have found numerous inaccuracies (some of them sizeable). Further, radiologists had missed a brain lesion on MRI scans for more than a 5 years, and when it was eventually spotted, a subsequent brain biopsy literally...more
Karen
Groopman, an oncologist, looks at the way doctors perceive data and make judgments about patient care. He includes discussions on how radiologists process visual data, how doctors make decisions about prescriptions, how oncologists balance treatments, side effects, patient preference and doctor bias in order to design a treatment plan, how pharmacy companies influence doctor care, etc. I have long perceived medicine to be an interpretive art, supported by data. But Groopman well illustrates this...more
Courtney
Seems well-written for an audience of both doctors and laypeople alike. As a non-doctor, I found the anecdotal illustrations the author told particularly engaging (similar to short mystery/suspense stories) though some of the technical explanations of disease and treatments made my eyes glaze. I especially liked how the book recounts questions patients should ask doctors, in order to help the doctor think better--doctors are, after all, subject to the human tendency to have off and on times wher...more
Valerie
This was a phenomenal book that changed the way I looked at every doctors visit I've ever had, along with questioning at least one diagnosis from my past.

Groopman told story after story about how once one doctor gives you a diagnosis, most other doctors will shut down their "cognitive reasoning" and never question that diagnosis and will keep trying to treat something you may not have. In some stories, this resulted in the death of a patient. He also talks about how physician lore and influence...more
Christina
I read these medical narratives because I'm interested in the case studies, and I just can't seem to get enough of them. How Doctors Think is full of interesting stories, and I appreciated that Dr. Groopman used the complete names for diseases and disorders. I never felt that his tone was condescending in the least, maybe because the book is intended for physicians and laypeople alike. His thesis is that misdiagnoses most often occur because of doctors' cognitive errors, and that these errors ca...more
Helen
Dr. Groopman is the chair of medicine at Harvard Medical School and chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston. The idea for this book came to him when he realized his interns, residents, and medical students did not readily think deeply about their patients’ symptoms to arrive at a diagnosis. Frequently, the students’ conclusions were correct, but when they weren’t, there was potential for things to go terribly wrong.

Using real-life examples, Groopman expl...more
Willa
Jun 04, 2009 Willa rated it 4 of 5 stars
Shelves: 2009
This book was primarily about habits of thinking that can lead a doctor to misdiagnose a case or miss clues that make a difference in treatment. One example -- a woman who was underweight, suffering from loss of bone and kidney issues, who went from one doctor to another and had a case file which labeled her as suffering from anorexia and bulimia. Ultimately she turned out to be suffering from severe celiac disease.

Using many examples of this sort, including some from his own life, Dr Groopman...more
Michael
Here's a book I'd recommend to everyone. Patients will benefit by learning how their doctors think and, importantly, how to help them think. Doctors will benefit by becoming more aware of the kinds of cognitive errors they're prone to make and how to avoid them (or at least to decrease their incidence).

Here are some lessons I've learned:
1. If yours is a difficult case that's getting worse after initial treatment, you can ask your doctor: "What else could it be? What is the worst thing it could b...more
Andrew Griffith
Some of my comments and lessons from the book.

Doctors, like all of us, are subject to many of the 'fast thinking' pattern recognition (System 1), to use Kahneman's phrase as all of us. According to one study cited by Groopman, some 80 percent of misdiagnoses could be attributed to a cascade of cognitive errors, not lack of medical knowledge.

Groopman walks through a large number of examples from a range of medical fields to illustrate some of the more common cognitive errors:

- Attribution errors,...more
Susan
I can sum up the whole book with this little syllogism:

-Humans make mistakes.

-Doctors are human.

-Therefore, doctors make mistakes.

Ta-da!

Okay, just kidding. There's way more to it than that. You hear a lot about how as a patient you have to "be your own advocate"; How Doctors Think will give you a blueprint of what to do and say to accomplish that goal.

In Groopman's exploration of the myriad ways doctors and patients miscommunicate, it's nice that he doesn't adopt a blame-the-patient tone; nor d...more
Stef
Groopman describes various cases from his practice and those of other doctors, as well as a case in which he was a patient seeking diagnosis and treatment. He uses these cases to discuss the thinking errors that cause diagnostic mistakes and oversights, and the ways that the medical system perpetuates diagnostic mistakes once they are made. He is honest and so are the other doctors he interviews. He writes very clearly and some of the stories are really compelling.

I have a lot of experience with...more
Joe
How often do you think about -- How you think? My take is that in Medicine, when your thinking is not correct, the patient returns to the Doctor. It's a good thing that Dr. Groopman took his difficult patients clue -- and decided to evaluate why he sometimes mis-diagnosis some patients.

I found this helpful in that I also have the same tendencies...1. To lump similar things into a category and sometimes make false assumptions. 2. Feel like I've done everything ... when if I had pushed just a litt...more
Michael DiLeo
I didn't even mean to read this book. I picked it up for someone else, but happened to start it and couldn't stop. Groopman is trying to provide what he calls a "conceptual framework" for the mental errors doctors make in clinical diagnosis. He identifies three types of errors: anchoring (focusing on initial symptoms and making a snap judgment), availability (judging based on familiar seemingly relevant examples) and attribution (stereotyping the patient as a certain personality type and letting...more
Sara
Recommended for anyone who is looking to understand more about how the American healthcare system works, and how to get more out of the limited facetime we have with physicians. One of the major challenges inherent in the US healthcare system is the fragmentation of information: a test result one specialist orders may never be seen by one's PCP, or medical data is easily lost when a patient moves to a new state and neglects to have records tranferred. Dr. Groopman explains what makes a doctor es...more
Shel
I had to drive 12 hours by myself today and went to the library to see if they had anything interesting to listen to, and took out this on audiobook. It was interesting enough to keep me awake and my mind occupied for the whole trip! Groopman talks about all of the various types of mistakes that doctors make - not technical errors like labeling the wrong limb on an x-ray or miscalculating a drug dosage, but errors in diagnosis and treatment that could have been avoided had the doctors been more...more
Lise
This book covers the various cognitive biases and errors that influence a doctor's diagnosis process. It also addresses how patients can be their own best advocate by asking the right questions (i.e. "What's the worst thing this could be?")

One of the chapters I found most intelligent was the chapter on epistemology, or how doctors know what they know. Challenging oneself to answer the question of, "How did I learn this?" sometimes can reveal that medical diagnosis is no more than, "Well, the doc...more
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