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How Doctors Think 1st Edition
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From Publishers Weekly
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
From Bookmarks Magazine
Copyright © 2004 Phillips & Nelson Media, Inc.
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Top Customer Reviews
On the positive side, Dr. Groopman's book is an attempt to bring to light some issues surrounding errors in medicine, a topic that is not discussed often enough in the medical and general literature. He discusses how physicians can make cognitive errors when they attempt distill an array of scattered bits of information in order to arrive at a conclusion to the question: what condition is this patient suffering from? He also tries to identify forces in the current American medical system that undermine a physician's ability to think more broadly and deeply about a patient's illness. His limited efforts in these areas can be a helpful starting point for patients, medical students, and physicians who are beginning to grapple with a simple fact: doctors are human, and they make mistakes.
On the negative side, Dr. Groopman offers little in the way of concrete suggestions for clinicians to fix the problems he identifies. He indicates the current system is driving physicians to see more patients in less time, but offers no realistic proposals for doctors or patients that would allow for a less hurried atmosphere. He makes a number of suggestions on how physicians can think more clearly: think outside the box, be wary of "going with your gut", don't judge a patient by her outward appearance, be prepared in your mind for the atypical patient, consider the possibility of more than one diagnosis, and other pearls of wisdom. While they are good recommendations, they fall far short of a concrete program for improving one's diagnostic skills and thought processes.Read more ›
For more than a decade, Groopman's trenchant analyses have always been illuminating, and he has a rare gift for communicating them.
This is one of the best books that he has written, about one of the issues that may lead to medical errors: simply not thinking well. It is a very real factor. We all - and not just doctors - jump to conclusions; believe what others tell us and trust the authority of "experts." Clinicians bring a bundle of pre-conceived ideas to the table every time that they see a patient. If that have just seen someone with gastric reflux, they are more likely to think that the next patient with similar symptoms has the same thing, and miss his heart disease. And woe betides the person who has become the "authority" on a particular illness: everyone coming through his or her door will have some weird variant of the disease. As Abraham Maslow once said, "If the only tool you have is a hammer, you tend to see every problem as a nail." To that we have to add that not all sets of symptoms fall neatly into a diagnostic box. That uncertainty can cause doctors and their patients to come unglued. Sometimes when doctors disagree it is based not on facts, but on different interpretations of this uncertainty.Read more ›
Throughout, he considers the doctors' time constraints, the pressures on them to see a certain number of patients each day, the limitations on tests which are imposed by insurance companies or by hospitals themselves, and the many options for treating a single disease. He is sympathetic, both toward the patient and the physician, and, because he himself has had medical problems, he provides insights from his own experience to show how physicians (and patients) think.
Case histories abound, beginning with the 82-pound woman, whose celiac disease was not diagnosed for fifteen years. Here Groopman analyzes the uses and misuses of clinical decision trees and algorithms used by many doctors and hospitals to assess probabilities and make decision-making more efficient. Sometimes, however, it is necessary for a doctor to depart from the algorithm and obey intuition. Recognizing when the physician is "winging it"--depending too much on intuition and too little on evidence--is a challenge for both patients and other physicians.Read more ›
Most Recent Customer Reviews
Well written. Interesting perspective from the doctors perception to the patient to actively participate. Read morePublished 12 days ago by wtxskater
Great book which isn't just for medical professionals. Gives excellent insight into the world of medicine and provides new insights and understanding. Read morePublished 26 days ago by Mark
This is an excellent book and my wife said she'd like to read it on her iPad. Unfortunately when I tried to loan it to her under product details I found "Lending: Not... Read morePublished 3 months ago by Thomas Grzymala
You need to be your own advocate when it comes to consulting in medicine. A very very good book about this subject.
Not a complete page turner but definitely a vehicle for lay patient and professional alike to better understand the pitfalls and mind traps that allow some patients' true diagnoses... Read morePublished 4 months ago by James J. Denike
First rate for a look behind the curtain at what our docs are up to when and why they're not always right.Published 4 months ago by Kurt