How Doctors Think | Jerome Groopman | Great shape, great service!

How Doctors Think | Jerome Groopman | Not for the average patient

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How Doctors Think

	How Doctors Think Jerome Groopman Mariner Books, 2008 - 336 pages average customer review:based on 155 reviews view larger image
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highly recommended

Great shape, great service!

The book I ordered came promptly, was packaged well, and was in pristine condition. I was very pleased.

Not for the average patient

The seed for the idea of this book was planted several years ago while Dr. Groopman was in the course of supervising interns, residents, and medical students on rounds in a teaching hospital. While conducting the rounds in a customary manner, Dr Groopman became disillusioned by the responses of his charges. While these were unquestionably intelligent and educated students of medicine, he observed a failure in their ability to question, listen, and observe. At that point, as their instructor, he began to question how doctors are trained to think about their patients and the patients' problems.

This book delves into the traditional methods that doctors have used to make decisions, as well as many of the problems that currently face the health care industry and the ways in which they interfere with the doctor and patient relationship. In today's world, the doctor must not only do the best possible job for his patient , but also comply with insurance companies, lawyers, algorithms, and flowcharts. Historically, doctors have learned as "apprentices" to other doctors by observing, doing, and teaching. But, even with the advances of modern medicine, doctors are still required to make many judgment calls. Medicine is never an exact science.

Another area that is explored is Doctor/patient communication. Inability to engage the patient in meaningful dialogue is one of the problems encountered. Another problem in "doctor thinking" is falling back on stereotypical thinking and not approaching the patient's problems as a unique circumstance.

The book also details the pitfalls that doctors can enter into by not evaluating their diagnostic processes. Fatigue, fear of failure, and interpreting data inappropriately are but a few. A physician by nature refers to his own area of expertise when evaluating a problem. For instance, if a patient visit's a surgeon, the surgeon looks at the patient as a surgical candidate. This is a generalization, but in a nutshell, a doctor wants to use skills with which he is most familiar. Dr. Groopman also calls attention to the influence of the doctor's decision on the "last bad experience". A fear of repeating an error sometimes clouds the judgment of the practitioner.

As a practicing health care provider, I found this book to be pleasantly readable and very informative. The book is not, however, written at a level that an average patient would be able to understand. The vocabulary is at a college level, and the writer assumes at least a basic understanding of medical terminology and anatomy. In one case, I was baffled by a reference to Sisyphus. Which mythological character was this and what was his dilemma? (The text referred to a physician that felt like Sisyphus when he encountered patients that did not care for themselves. Sisyphus was in fact the being that tried to roll the boulder up a giant hill.)

While How Doctors Think is a worthwhile read that provides great insight to how doctors are trained and the many challenges they face, I am skeptical that this book will improve communication and outcomes for the average patient.

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Interesting

Interesting and insightful look behind the scenes when you have a potentially very serious medical condition

How Doctors Think

I had checked out a copy from the library. A friend who had recently had to deal with her parent's illnesses started reading it and couldn't stop. So I bought a copy for her. It is worth having on hand as it has many ideas about dealing with doctors and knowing when to support, question, review or seek other ideas. Some of their thinking reflects the training of medical school and it is helpful to know why certain patterns of thinking are so prevalent.
I also appreciated the chapters on reading xrays, tests, etc. and how much that can vary from expert to expert or time to time. It makes me realize that if I don't put effort into my doctor's analysis, I may well get an inaccurate one.

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How Doctors Think

Groopman brings a refreshing account concerning the cognition abilities of physicians and its residual affects upon their patient interactions. He conveys that physicians inadvertently rely upon their initial professional socialization processes while in medical school by learning different matrices in determining diagnoses. That this mindset is ingrained with some physicians does reflect negatively on patients with deleterious effects. Especially, as these physicians becomes more entrenched in the course of their medical careers, in terms of his/her professional demeanor and acumen. That external forces also influence these purportly medically derived diagnoses: indifference, reimbursement, and conflict of interest. He infers that reluctancy exists among some physicians in delving into the diagnosis, treatment and prognosis for their patients. This grays the physician-patient relationship that the latter believes about the former.

Chapter nine really illustrates the effect of the pharmaceutical industry upon physicians. Groopman states that there is a definite need for pharmaceutical research in exploring effective medications, but delineates that ethical standards are circumvented. He places the reader's perspective into the mindset of physicians by illustrating their practical terminology and analysis matrices. This is an excellent read for researchers, physicians, medical ethicists, social scientists and students to gain further insight into the cognitive reasoning by physicians as they conduct formulate and conclude medical diagnoses.

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