How Doctors Think

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Houghton Mifflin Harcourt, Mar 12, 2008 - Medical - 320 pages
12 Reviews
On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong -- with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can -- with our help -- avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track.

Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems.

How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.

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I do hate anecdotes, particularly coming from a doctor. And the book is rife with them, often basing whole chapters around specific anecdotes. While often compelling, they simply aren't data - was this person's experience a bad one, or simply reflecting the complexity of diagnosis? This book seemed to be aimed at doctors and patients, but suffered "middle ground syndrome", where the overall message spoke to neither. The chapter on a Jewish single mother's adoption of a baby was particularly galling, as its central message seemed to be that faith is great and can solve problems. As an atheist, I found this less than compelling and completely overwhelmed the more interesting message - persistence and careful reading of the medical literature was what solved the case. Certainly it wasn't a miracle. The entire book could have been reduced to a pamphlet consisting of the final chapter - ask questions, ask if the diagnosis is the sole one that could be reached, ask if your doctor is a good fit. As a layperson with an interest in the science of medicine, this lengthy discourse on the art of medicine left me irked. 

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An interesting discussion of the various cognitive biases and errors encountered in diagnosis and treatment decisions. Coming from the point of view of a software developer, this book underlines both the similarities and differences between debugging and diagnosis.

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About the author (2008)

Jerome Groopman, M.D., holds the Dina and Raphael Recanati Chair of Medicine at Harvard Medical School and is chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston. A staff writer for The New Yorker, he is the author of How Doctors Think, The Anatomy of Hope, Second Opinions, The Measure of Our Days, and other books.

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