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Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together Hardcover – September 4, 2012

4.4 4.4 out of 5 stars 45 ratings

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“As a physician and a social scientist, Peter Ubel is unparalleled in his understanding of some of the most important decisions we are facing, or will face.”
—Dan Ariely,
New York Times bestselling author of Predictably Irrational

“His ideas are important, his style is accessible (with the right balance of humor and compassion) and his topic is timely.”
—Dan Gilbert, author of
Stumbling on Happiness and host of “This Emotional Life”

All too often, problems in communication between a doctor and patient can lead to bad medical decisions. As a practicing physician and a behavioral scientist, Dr. Peter Ubel has a unique understanding of this dangerous situation—and in Critical Decisions he addresses the problem while revealing a new revolution in medical decision-making. Critical Decisions combines eye-opening medical stories with groundbreaking behavioral science research, while offering important information and common sense solutions to promote better doctor/patient relationships thereby ensuring that the right decision will be made in life-saving medical situations.

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Editorial Reviews

From Booklist

In this passionate plea for patient empowerment, Ubel, a physician with a background in bioethics and behavioral science, promotes ways to assist people in making medical decisions. The best choices must always take into account a patient’s particular values. Major obstacles to shared decision-making by patients and their doctors can include medical terminology (a language barrier), empathy deficit (physicians failing to grasp the emotional needs of patients), and the inability of patients to adequately understand medical evidence (e.g., to comprehend statistics). Ubel uses the stories of patients and his own clinical experiences to illustrate his points. An excellent chapter describes the treatment of his wife’s invasive breast cancer along with the many medical questions and decisions that faced the couple. Ubel’s advice to doctors is solid: “Physicians need to offer recommendations with humility and in a manner that invites divergence of opinion.” His suggestions for patients are equally sage: Be informed. Listen carefully. Ask questions. Get guidance from family, friends, and doctors. Don’t rush big decisions. Always remember, you’re not alone. --Tony Miksanek

Review

“Decisions affecting our health and our loved ones’ are some of the most important that we make. As a physician and social scientist, Peter Ubel is unparalleled in his understanding of the influences that guide our medical decisions, and here he shows us how we can make better decisions.” (Dan Ariely, bestselling author of The Honest Truth About Disohnesty and Predictably Irrational)

“Written with clarity and a touch of humor, this is a quick and thoughtful read, a good choice for patients, and a must for medical professionals.” (
Library Journal)

“Ubel’s advice for doctors is solid, and his suggestions for patients are equally sage.” (
Booklist)

Product details

  • Publisher ‏ : ‎ HarperOne; 1st edition (September 4, 2012)
  • Language ‏ : ‎ English
  • Hardcover ‏ : ‎ 368 pages
  • ISBN-10 ‏ : ‎ 0062103822
  • ISBN-13 ‏ : ‎ 978-0062103826
  • Item Weight ‏ : ‎ 1.15 pounds
  • Dimensions ‏ : ‎ 6 x 1.17 x 9 inches
  • Customer Reviews:
    4.4 4.4 out of 5 stars 45 ratings

About the author

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Peter A. Ubel
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Dr. Peter Ubel is a physician and a behavioral scientist at Duke University. He is the author of three previous books: Pricing Life (MIT Press, 2000); You're Stronger Than You Think(McGraw-Hill, 2006); and Free Market Madness: Why Human Nature is at Odds with Economics--and Why It Matters (Harvard Business Press, 2009). He has contributed to The New York Times , The Los Angeles Times, Psychology Today, and The New England Journal of Medicine , among other publications.

Customer reviews

4.4 out of 5 stars
45 global ratings

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Customers say

Customers find the book engaging and easy to read. They find it enlightening and thought-provoking, providing real meaning and context from history and patient experiences.

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14 customers mention "Readability"14 positive0 negative

Customers find the book engaging and easy to read. They describe it as an important, interesting read with revealing anecdotes. The language is accessible and the author is described as a storyteller.

"...In summary, this is an excellent and engaging book for people interested in more meaningful partnerships with their physicians..." Read more

"...The book is well organized and written clearly. He includes references and additional resources. The topic is incredibly topical...." Read more

"Interesting and fast read. Amusing and revealing anecdotes. Perhaps there isn't much of a solution...." Read more

"...There lies the conflict I see with this otherwise excellent book...." Read more

11 customers mention "Insight"11 positive0 negative

Customers find the book enlightening and thought-provoking. It provides real context based on history and patient experiences. Readers appreciate the author's ability to explain complex ideas clearly. The topic is highly topical, with real stories illustrating decision making and candid personal thoughts.

"...He makes effective use of his own experiences with patients (and as a patient) to showcase the kinds of issues that arise in shared decision making..." Read more

"...he leads the reader through various stages such as the advent of science, the rise of knowledge as..." Read more

"Interesting and fast read. Amusing and revealing anecdotes. Perhaps there isn't much of a solution...." Read more

"...But the historical and theoretical background, though interesting, may discourage someone actively making medical decisions from using this book in..." Read more

Top reviews from the United States

  • Reviewed in the United States on September 11, 2012
    As a fellow researcher in the psychology of medical decision making, I've had the pleasure of following Dr. Ubel's innovative work for years. In Critical Decisions, he applies his notable skills as a physician, a bioethicist, and a behavior scientist to explain how patients and physicians can find themselves stymied by the need to work together to make medical decisions and how patients, in particular, can make better decisions.

    The book begins with a historical account of the emergence of "patient autonomy" in medical decision making as a moral and legal paradigm, and shows why putting medical decisions solely on the patient, although perhaps a necessary counterweight to centuries of physician paternalism, is also highly problematic, particularly in light of the psychology of decision making which challenges the assumption that simply informing patients is sufficient to enable them to make better decisions. Ubel traces the much more recent ascent of "shared decision making", including the development of patient decision aids, and points out the need for improvements in both patient and physician communication. As patients being more active, he points out, physicians need to be better prepared for active patients. He concludes with eight tips for patients to better partner with their doctors.

    Ubel has a real flair for explain complex ideas - medical, legal, economic, or psychological - in straightforward and readable language. He makes effective use of his own experiences with patients (and as a patient) to showcase the kinds of issues that arise in shared decision making and point a way forward.

    Because I know Ubel's work well, I know there are fascinating and important studies that didn't make it into this book. For example, he points out that people without a colostomy assume that living with a colostomy will be worse than it is (according to people who have a colostomy), but he doesn't cover his later study that shows that even people who have formerly had a colostomy (since reversed) also misremember what it was like and return to assuming that a new colostomy would be worse than their past experience would suggest. Of course, collecting all of Ubel's findings would take several additional volumes, so it's not much of a fault. Hopefully, this will lead readers to explore Ubel's (and other) further work beyond the book.

    In summary, this is an excellent and engaging book for people interested in more meaningful partnerships with their physicians (as well as for physicians trying to understand how to partner with their patients). It's going on my Amazon list of great books on medical decision making.
    3 people found this helpful
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  • Reviewed in the United States on February 3, 2013
    This book should be required reading for all the following: physicians and nurse practitioners, current patients, future patients, potential patients, family and friends of patients, patient advocates, health care policy makers, and those who write or think about health care or behavioral economics. If you aren’t in any of those groups, don’t bother reading it.

    First some basic comments. Dr. Ubel is a physician and ethicist with a humanities background. He has been both a patient and the family support for patients, so his qualifications are superb. The book is well organized and written clearly. He includes references and additional resources. The topic is incredibly topical. I’ve read it once, taking notes, and will be reading it again, after which it will remain on my shelf for reference.

    Now, about the book itself.

    He sets his discussion of patient choice within a historical perspective. Beginning with the distant era of Hippocrates where paternalistic comfort was the core of professionalism (a time when comfort and hope were all that doctors had to offer), he leads the reader through various stages such as the advent of science, the rise of knowledge as power to be wielded unilaterally by the authoritarian physician, the beginnings of the patient emancipation process with Karen Ann Quinlan and the struggle over who had the right to make decisions about end of life care, to patient empowerment and engagement in shared decision making, and finally to the needs for educational and cultural changes to support collaboration between patients and their clinicians.

    Within this historical narrative he uses anecdotes (both his and others), medical science (with some nice discussions of screening, breast cancer, and prostate cancer), and behavioral economics to trace a path from what was through what is to what we should be striving to create.

    A thoroughly enjoyable and educational book. Buy it and read it.
    3 people found this helpful
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  • Reviewed in the United States on November 30, 2013
    Interesting and fast read. Amusing and revealing anecdotes. Perhaps there isn't much of a solution. The end of the book leaves a feeling of wishy-washiness without any concrete solutions to take away. Thus one star taken away because in the end, this feels more like a collection of anecdotes rather than a "study" of the problem.
    5 people found this helpful
    Report

Top reviews from other countries

  • Megha
    5.0 out of 5 stars Great read to understand the patient choice revolution
    Reviewed in India on June 30, 2018
    Great read to understand how patients today have so much more power (but at the same time more choices and confusion) than they did 50 years back.