How Doctors Think

How Doctors Think❰Download❯ ➵ How Doctors Think Author Jerome Groopman – 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 t 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 conseuences In this myth shattering book Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make Groopman explores why doctors err and shows when and how they can with our help avoid snap judgments embrace uncertainty communicate effectively and deploy other How Doctors Kindle - skills that can profoundly impact our health This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses How Doctors Think offers direct intelligent uestions patients can ask their doctors to help them get back on trackGroopman draws on a wealth of research extensive interviews with some of the country’s best doctors and his own experiences as a doctor and as a patient He has learned many of the lessons in this book the hard way from his own mistakes and from errors his doctors made in treating his own debilitating medical problems How Doctors Think reveals a profound new view of twenty first century medical practice giving doctors and patients the vital information they need to make better judgments together. 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 she has stopped thinking There's nothing wrong with you Even if your problems are psychogenic they're still problems and you are still sufferingThings you can say to your doctor to help himher with your case What's the worst this could be? Is it possible that I have than one problem? Let me tell you what is really frightening me Can I tell you the story again as if you'd never heard it? Is it possible that I left out something important that I don't realize is important? When you say 'improvement' do you mean 'cure'? How likely is this test to have a false positive rating? What about a false negative rating? Are you doing this procedure because you are confident it will work or are you doing it because you don't know what else to do? Do you need time to think about this? Do you want to call or e mail me or should I schedule another appointment?Other interesting information from this book• Studies show that the sicker you are the likely your doctor is to dislike you Sad but true • Patients seen as noncompliant are also generally disliked Doctors notice an apparent refusal to follow diet exercise and medication regimes but do not always realize that other factors such as illiteracy may be the reason for noncompliance• Other studies show that a doctor will interrupt a patient describing symptoms within 18 seconds• People tend to think that ER doctors can give a complete physical exam and tell them that they're completely healthy but ER doctors are focused on making sure that whatever may be wrong with you does not kill you in the next three daysExcellent and thoughtful book but I subtracted one star for a minor problem Dr Groopman always uses he when referring to doctors in general This made me crazy because he's trying to note differences in older and younger doctors and I think a rather substantial difference is that about half of younger doctors are female Also many of the most successful and thoughtful doctors he interviews are female Also HE IS MARRIED TO A FEMALE DOCTOR Arrgh He refers to patients in general as they This kind of sexism is so easy to edit out but nobody bothered and it rankles that nobody at the publishing company advised him that well over half the book buying audience is female Everyone needs to be their own advocate for their health care A good first step is to understand how doctors think and that's what this book attempts to do The book generally focuses on the problem of incorrect diagnoses Following each example of incorrect diagnosis there is an analysis of the reasons why the errors were made Then the authors suggests ways doctors and patients can avoid similar problems in the future There are numerous ideas and suggestions for patients to use in improving their chances of being correctly diagnosed Generally speaking my reaction to most of the examples in the book was that the docors are human and they can slip up occasionally The book suggests that doctors are correct about 85% of the time Incidentally that's about the same rate of accuracy as modern weather forecasting What I was most alarmed to learn about was how inaccurate radiologist and pathologists were After hearing the accuracy rates for those professions I think it to be unwise to allow a serious operation be performed based upon the test results reported by a single radiologist or pathologistsThe author is a doctor himself One of the most interesting examples in the book was his own personal story of finding a solution for pain in his right hand I lost count but I think he visited about six different specialists trying to find a solution to the problem I noticed that his wife who's also a doctor insisted on coming along to some of the visits with doctors to make sure her husband would ask the corrrect uestions He used his medical connections to get in to see what are considered to be the top experts in the nation and even he was unhappy with the way he was treated If he wasn't happy imagine what happens to the rest of us In the end he had a surgery done that gave him 80% full use of his hand a bit short of perfection However if he had gone forward with about 4 of the 6 proposed operations the result would have either been no improvement or maybe ending up in a worse conditionThe following is the review from my PageADay Book Lover's calendarNobody’s perfect not even your doctor But most doctors get most diagnoses right most of the time Jerome Groopman Harvard Professor of Medicine and essayist for The New Yorker examines those times when things go wrong The uestions Groopman asks are crucial What assumptions do doctors make about patients that lead to misdiagnoses? And what can you the patient do to help your doctor think clearly and avoid fatal jumps to conclusions? This is one book that can definitely improve your health 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 also spread throughout the book treatment and other factors that may influence a physician with respect to a patient I’ve read this book twice now and have gotten different things from it each time The first time was during my second year of medical school and I re read my review of it remembering how confusing just the process of arriving at a differential diagnosis can be Last year when I read the book I read it almost as a patient than a physician Now in the middle of my third year of medical school I understand about the process of arriving at a differential diagnosis and the book had significance to me in a way it did not before The main lessons that I gleaned from the book1 Listen carefully to the patients the diagnosis is in the history2 Don’t get caught up in what the patient has been diagnosed with listen to the story yourself3 Be conscientious – have a method and stick to it even in the face of an obvious diagnosis4 Ask the patient what they’re most worried about and address it5 Consider your feelings towards the patient – are they affecting the diagnosistreatment?6 If a diagnosis is wrong have the patient tell you the story again from the beginning7 Consider that there may be than one problem8 Ask yourself what doesn’t fit with the picture9 Don’t take gifts from drug companiesThere is one thing that I disagree with in this book – that a patient’s problems should be considered psychological once all other “physical” problems have been ruled out I think that this discounts the importance of psychological problems – seeing them as a catch all for things that the physician cannot explain – and creates a rift between the patient and physician where the physician failing to diagnose the patient turns to psychiatry I also thing that he did not take into account one major thing – disbelief of the patient It is rampant So often a patient will come in and the physician rolls hisher eyes and easily discounts the patient’s symptoms It’s possible that this comes with time and practice and that maybe I haven’t made it there yet Not always though I saw an intern groan and moan about this patient who had a number of complaints and appeared to be annoying her – the patient turned out to have metastatic colon cancer I think that this plays a large role in the patient – physician interaction and should be studied closely “Should I believe you?” appears to be a uestion on many physicians’ minds during their interactions with patients and I’m sure that patients can sense itI loved this book I hope he writes I plan to read it again in a few years Unfortunately I presently have no time to write a proper review of this outstanding book So I just say that it is one of the most fascinating and maybe THE most fascinating medical book I have ever readThis book was written for doctors AND patients So yesterday I gave a copy of this book to my primary care physician I did this for altruistic AND for selfish reasonsIf you want to do yourself a favor please read this book buy extra copies to make them presents for your loved ones and last but not least give a copy to your doctor These investments may save your andor other other people's lives This book was so good It illustrates the importance of the patient doctor relationship in the aspects of psychological well being diagnosis and treatment of patients I found that the audiobook was so effective in its delivery and reading of the book I was very engaged with a constant eagerness to learn Groopman emphasizes prime mistakes seen in medical practices of doctors in different specialties At some point in the last chapter he states Without risking failure there was zero chance of success This is such a true statement when it comes to medical practice and building relationships with patients It's crucial to listen to the patient without interruptions to record their stated symptoms accurately to avoid making rushed decisions to arrive at an unnecessary diagnosis that could be very well avoided 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 the caregiver is oftentimes in the best position to solve the mystery However I couldn't help thinking about the patients who lack the resources andor the intelligence to communicate effectively with ones doctor or to conduct research necessary in finding the correct diagnosis andor doctor A sad truth Who will be their advocate? Nevertheless intellectually pleasing A book that helps clinicians to assess the way they think and to try eliminating the diagnostic errors by diagnosing the doctors' thinking pitfalls anchoring attribution and availability types of errorsIn my opinion; stereotyping is the most common cause of diagnostic errorsThe expert clinician would be better in diagnosis but unfortunately due to the 'stereotypes' they had so it's a 'double edged sword' every clinician should relay on his experience but not bypassing the ABCs 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 errorsrutsgaps 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 proactive to ask better uestions and thus help themselves by helping the doctor find the correct diagnosis or best treatmentGroopman organizes his points around lots of interesting anecdotes so I didn't find this book dry at all just somewhat repetitive If you're interested in the medical field at all or perhaps have had an illness that resisted easy diagnosis I definitely recommend it You don't have to read the whole thing unless you really get into it The introfirst chapter and the one about his hand are especially intriguing I read this book after having a fascinating experience this spring with traditional Chinese medicine TCM in which my acupuncturist solved a medical mystery for which Western medicine had 0 answers The problem was basically an imbalance of the sort that isn't even in the Western lexicon TCM views the body in a totally different way But for me this made how doctors think the subject not the book seem frustratingly constrained with very limited training in or willingness to explore truly holistic health 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 Groopman's free flowing anecdotal style is his strength and his uniue 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 are influenced by a messy intersection of money ego and faithhope He guides the reader to this conclusion by recounting his interviews with many different specialists and even a pharmaceutical company executive The solution is informed choice a comprehensive understanding of the risks and benefits of all available treatments which also encompasses an understanding of how different doctors think and how factors like money personal bias and tradition influence that thinking This chapter is worth a read and it's unfortunate that it appears near the end of the bookThe rest of the book however feels incomplete Groopman often fails to consider the epidemiological big picture in certain key moments For example he criticizes the use of patient templates versus traditional open ended uestioning in reaching a diagnosis because the former tends to restrict a doctor's ability to reason Ch 4 Gatekeepers He implicates the financial pressures that lead insurance companies to increase the number of patients a primary care physician sees on a given day and therefore necessitate the development of templates This sounds reasonable on its surface but the uestion at the crux of the matter goes unasked; namely does open ended uestioning lead to different outcomes versus patient templates at the population level? After all checklists developed at Cook County hospital improved the overall accuracy of diagnosis of chest pain thereGroopman also introduces many unresolved contradictions throughout the book While his description of his own personal journey with his mysterious wrist pain and its elusive diagnosis is interesting at an anecdotal level the lessons drawn from that journey are puzzling at best Groopman praises the young doctor for ignoring data from the all mighty MRI scan and paying heed to pertinent data in reaching the correct diagnosis Ch 7 Surgery and Satisfaction This contradicts one of the major running themes in this book Doctors are often lead astray by confirmation bias ie the tendency of doctors to ignore data that contradicts their impressions while favoring data that agrees with them What I'm left to wonder is what distinguishes this young doctor's insight from the myriad of doctors who employ seemingly similar thought processes but arrive at wrong diagnoses In other words Groopman seems to praise and reject the exact same thought process based on the success or failure of the outcome As a future doctor myself this doesn't really help me understand how to avoid cognitive errors In Chapter 8 The Eye of the Beholder Groopman seems to support giving radiologists a complete patient history to aid in the interpretation and diagnosis of medical imaging but he fails to explain how this would avoid the error of availabilitydiagnosis momentum a shortcut in thinking that causes people to assign the likelihood of an event based on the relative ease with which examples come to mindThis book is not without its occasional gems I like the idea that the perfect is the enemy of the good in reference to managing patient outcomes pre and post surgery Ch 7 and as I mentioned in the first paragraph of this review I found Groopman's analysis of marketing and motivation in medical decisions to be nuanced insightful and well articulated That said however Groopman leaves too many unresolved uestions for me to consider this a persuasive work as a whole

How Doctors Think Kindle Ø How Doctors  Kindle -
  • Hardcover
  • 320 pages
  • How Doctors Think
  • Jerome Groopman
  • English
  • 22 July 2015
  • 9780618610037