How Doctors Think
* "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
Jerome Groopman, Harvard professor of medicine, AIDS and cancer researcher, and New Yorker staff writer in medicine and biology, isn't new to the popular medical-writing scene. Before How Doctors Think, he penned three other books__The Anatomy of Hope, Second Opinions, and The Measure of Our Days__that explore the role of art in the hard science of medicine. Here, Groopman's readable prose emphasizes the human element, the give-and-take so important to successful diagnosis and treatment. One cri...more
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
Using real-life examples, Groopman expl...more
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
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
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
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
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
Using many examples of this sort, including some from his own life, Dr Groopman...more
The issue of pharmaceutical companies-doctors nexus has...more
-Humans make mistakes.
-Doctors are human.
-Therefore, doctors make mistakes.
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
Structurally it is a series of anecdotal case histories with input from physicians and appropriate citation of academic studies. Although it can be beneficial for patients I feel physicians get a bad rap. I got the impression that behind the scenes of many a medical conversation lurks the insurance company.
Today my guess i...more
I have a lot of experience with...more
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