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Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together Hardcover – September 4, 2012
| Peter A. Ubel (Author) Find all the books, read about the author, and more. See search results for this author |
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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.
- Print length368 pages
- LanguageEnglish
- PublisherHarperOne
- Publication dateSeptember 4, 2012
- Dimensions6 x 1.17 x 9 inches
- ISBN-100062103822
- ISBN-13978-0062103826
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“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)
From the Back Cover
We've all been there, sittinguncomfortably in a paper gownas a doctor impassively describesour prognosis. Sometimes it's simple andtreatable. Other times we get news wecan't fathom and then are faced withdecisions that are literally life and death.
In this revolutionary book, physician,behavioral scientist, and bioethicist PeterUbel, M.D., reveals how hidden dynamicsin the doctor/patient relationship keepus and our loved ones from making thebest medical choices. From doctors whostruggle to explain, to patients who failto properly listen, countless factors alterthe course of our care, causing things togo seriously awry.
With riveting stories of Ubel's own experiencein the field, his groundbreakingresearch, and his personal journey walkingloved ones through difficult treatmentchoices, Critical Decisions will foreverchange the way we communicate insidehospitals and medical offices, wherethoughtful decision making matters themost. Dr. Ubel has been on both endsof the stethoscope, and in this book,he shows how patients and doctorscan learn to become partners and worktogether to make the right choices. Fromchoosing to get surgery, to discussingthe side effects of a blood pressure medication,we can finally discover the toolsto improve communication, understandthe issues, and make confident decisionsfor our future health and happiness.
About the Author
Peter A. Ubel, M.D.,is a physician and a behavioral scientistat Duke University. An internationally renownedwriter and researcher, he is theauthor of three books: Pricing Life, You'reStronger Than You Think, and Free MarketMadness. He writes for numerous sciencepublications as well as the New York Times,the Los Angeles Times, Psychology Today,and The New England Journal of Medicine.
Product details
- Publisher : HarperOne; 1st edition (September 4, 2012)
- Language : English
- Hardcover : 368 pages
- ISBN-10 : 0062103822
- ISBN-13 : 978-0062103826
- Item Weight : 1.16 pounds
- Dimensions : 6 x 1.17 x 9 inches
- Best Sellers Rank: #1,675,201 in Books (See Top 100 in Books)
- #91 in Medicine & Psychology (Books)
- #630 in Doctor-Patient Relations
- #9,689 in Medical General Psychology
- Customer Reviews:
About the author

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.
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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.
Ubel's historical outline helps frame the provocative chapters that follow, on the irrationality inherent in so much of our most pivotal decisions. Based on years of cutting-edge behavioral research, much of it Ubel's own, I found these to be the most interesting part of the book. I'd encountered many of the studies in my own research on medical decision-making, but never before collected in such a coherent and powerful way.
Finally, Ubel closes with chapters geared toward preparing both physicians and patients for a new era of shared decision-making. This is perhaps the most "practical" part of the book for someone currently grappling with a medical decision, but it might lose its resonance if not for all the anecdotes and analysis leading up to it.
There lies the conflict I see with this otherwise excellent book. At its best, it would serve as a manual for people in the grips of a difficult medical decision. But the historical and theoretical background, though interesting, may discourage someone actively making medical decisions from using this book in the moment. On the other hand, though healthy laypeople should be interested in these issues, I wonder why they'd read an entire book about them (especially with 50 Shades of Grey within reach). Unless, of course, they have prior intellectual or professional interest in the material. Which brings me to the third potential audience: actual members of the health professions (doctors, nurses, etc.). I think every member of the health professions, or at least every student training to join them, should read this book. I've never seen the complexities of bioethics explained so pragmatically and evenhandedly. Worse yet, as a medical student, I've been barraged with outdated imperatives that contribute to many of the problems Ubel observes. I honestly think this could replace the entire decision-making component of medical school education, and much of the bioethics and communication curricula as well.

