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How Doctors Think: Clinical Judgment and the Practice of Medicine 1st Edition

13 customer reviews
ISBN-13: 978-0200000000
ISBN-10: 0200000004
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Editorial Reviews

Review


"This is a book that will be read with pleasure by anyone interested in how medicine is done and it is a book that should be required reading for all students starting their clinical training."--Journal of the Royal Society of Medicine


"Montgomery has certainly written a piece that will stimulate people to think more deeply about medical and wider health professional practice. It is a text I will recommend to students and colleagues."--PsycCRITIQUES


About the Author

Kathryn Montgomery is at Northwestern University.

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Product Details

  • Hardcover: 256 pages
  • Publisher: Oxford University Press; 1 edition (November 2005)
  • Language: English
  • ISBN-10: 0200000004
  • ISBN-13: 978-0200000000
  • ASIN: 0195187121
  • Product Dimensions: 9.3 x 1 x 6.4 inches
  • Shipping Weight: 1.3 pounds (View shipping rates and policies)
  • Average Customer Review: 4.0 out of 5 stars  See all reviews (13 customer reviews)
  • Amazon Best Sellers Rank: #733,152 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

25 of 28 people found the following review helpful By Daniel Sette Camara on January 3, 2007
Format: Hardcover
K Montgomery's book is the culmination of many years of working with physicians trying to dissect their way of reaching a complex diagnosis. She has an exceptional hability to put in words what takes 20 years of medical practice. Her concept of medicine not as science but a progressive growth based on experience ( memory of previous encounters with thousands of patients) and...science + new developments is simply revolutionary. Practical reasoning is the essence of how doctors think in the practice of medicine!!!!! This is one of the best books I ever read. I recommend HIGHLY
Daniel Sette Camara, MD,FACP,FACG, FASGE
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22 of 25 people found the following review helpful By SC on January 18, 2007
Format: Hardcover
I was thrilled when I first began reading How Doctors Think, and my feelings did not change when I finally finished the last page of the book. In honest,lyrical prose, Kathryn Montgomery eloquently articulates the complicated tapestry of the clinical decision-making process physicians often encounter in the face of clinical uncertainties and probabilistic medicine. Kudos to a beautifully structured deconstruction of the culture of medicine and medical training! I highly recommend this book to those involved in medical education curricular development. For those who are already medical students, residents, fellows, and attending physicians, I would suggest this as a must-read book on your reading list.
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18 of 21 people found the following review helpful By Robert T. Manning on July 2, 2006
Format: Hardcover
The best overview of physician thought processes I have read. Well written;thorough; should help non-medical persons understand the challenges physicians face in the diagnostic process and is an excellent guide for physicians who wish to organize and improve there clinical judgment. An MD
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3 of 3 people found the following review helpful By MGSWS on May 22, 2008
Format: Hardcover Verified Purchase
This is an incisive, and personal, analysis of how physicians think. It analyzes the foundations and processes behind physician's decision making, and their relationship to the patient. It also looks at some of the myths that add to the illusions that physicians sometimes project, both to bolster their persona as well as to hide the uncertainty that is behind many of their decisions. The writer is not a physician, which serves to give the book greater credibility, and is illustrated by her own anxiety regarding her daughter's cancer at an unusual age. As a physician, I found myself agreeing with most of her insights. Her analysis of the seating patterns and hierarchy in medical conferences is hilarious and accurate. Although she looked at a department of medicine, I think it holds true for mos specialties.

This book is not an easy read, and it can be fairly slow going because of the academic vocabulary and the sometimes obscure references to philosophy, science and literature. But it is worth reading. If you have been a patient, you may gain insight into your physician's decisions. If you are a physician, you may end up realizing you are not who you thought you were.
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2 of 2 people found the following review helpful By Irfan A. Alvi TOP 1000 REVIEWERVINE VOICE on September 7, 2009
Format: Hardcover Verified Purchase
This is an interesting book. The author, Kathryn Montgomery, isn't a doctor, but rather a "Professor of Medical Humanities" (PhD in English literature). For whatever reasons, she apparently developed a strong interest in understanding the practice of medicine at both social and individual levels ("how doctors think"), much like an ethnographer who becomes fascinated with a particular culture and strives for a deep and comprehensive understanding of it. Her interest in this area pays off, because she succeeds in discerning both the essence and nuances of medical practice, thereby penetrating far beyond the naive and harmfully misleading impressions and assumptions held by most patients, and even by many doctors themselves.

Her main finding, which she repeats and elaborates throughout the book, is that while medicine necessarily makes use of science and technology, medicine is NOT itself a science (an argument against doctors wearing white coats!), but rather an applied practice with humanistic aims, usually directed toward the particular needs of one patient at a time, accounting for the unique (and thus anecdotal) narrative unfolding of each patient's history. Because of variabilities among patients and general limitations in knowledge, clinical medicine is usually conducted in the midst of profound and unavoidable uncertainty, so judgment and skill based on attentive experience is necessary in order to make good decisions, and simple generalizable rules will never suffice by themselves. In this vein, because of its pragmatic case-specific orientation, the reasoning used in medicine must be a kind of interpretive practical reasoning (Aristotle's "phronesis") which is quite different from positivistic scientific reasoning.
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4 of 5 people found the following review helpful By tylerwiggum on July 9, 2007
Format: Hardcover
This is a fantastic book -- it is much more advanced than Groopman's book, and is probably aimed at a different audience. Groopman addresses the layperson, while Montogomery addresses issues and ideas that the average reader would have trouble with. She is a great writer, though, and this is well worth your time.
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3 of 4 people found the following review helpful By Chauncey Bell on July 30, 2007
Format: Hardcover Verified Purchase
There are two books with this same title, "How Doctors Think," that have arrived at more or less the same time. Dr Groopman's book will sell more copies, and is a useful book for building competence for managing both sides of the doctor-patient interaction. This book is something different. It is a historic milestone that offers extraordinary help to those who are committed to guiding the medical professions in shifting their orientations and competences for the challenges facing them. It arrives at the right moment, in that to effectively address these challenges will require new understandings of what doctors are and do, how they become what they are and how they are trained to do what they do. I am grateful that Ms. Montgomery has published it.
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