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How Doctors Think (2007)

par Jerome Groopman

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1,497459,528 (3.71)38
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.… (plus d'informations)
  1. 10
    Every Patient Tells a Story par Lisa Sanders (bragan)
  2. 10
    Mistakes Were Made (But Not by Me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts par Carol Tavris (espertus)
    espertus: Two interesting books filled with case studies demonstrating how trained professionals make incorrect decisions based on various types of cognitive errors.
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Great for those of us who have to deal with doctors on a regular basis and need to stay informed to get the best care possible.

I'll be interested in seeing how Watson the computer does as a doctor. ( )
  Sarah220 | Jan 23, 2021 |
"There is nothing in biology or medicine so complicated that, if explained in clear and simple language, cannot be undtersood by any layperson. It's not quantum physics." Dr. Lina Lewis (this is a quote from the author Dr. Jerome Groopman's mentor, and that attitude pervades this book.
The book describes many different ways doctors achieve their best work- and more, it gives ways for patients to help them remember the best techniques they were taught (or may not have been taught) in med school and residency.
It covers some of the challenges posed by modern health care that can prevent doctors from doing what they came to medicine to do- to heal and help. If all patients read this, we'd have better perspective and be able to work with our doctors instead of at cross purposes, and better health would be the result. ( )
  Tchipakkan | Dec 26, 2019 |
My first impression was to dismiss it as being anecdotal, but after finishing the book (because my father asked me to read it all) I have become newly sensitive to the role critical thinking must play in the choices we make about health care. ( )
  MaryHeleneMele | May 6, 2019 |
This is a great book. It's easy to read, has lots of patient stories as examples, and offers a perspective most patients don't see. No matter your malady, if you want to be an empowered patient the author offers you a series of questions you MUST learn to ask your doctors. ( )
  TheBibliophage | Mar 20, 2018 |
I picked this book up as a used book for 50 cents. Bought it just based on the cover title. It sat around my house for 2 months before I opened it to read the preface. Never put the book down. It was a quick read. Little technical jargon. If you liked the TV show "House" with the cranky genius doctor, you should enjoy this book. Its more about the psychology of decision making and what psychologists refer to as our cognitive errors rather then being about medicine. It over laps a lot with my reading on the same subject (cognitive errors) made by investors. These errors in thinking are part of the human brain. These apply to the highly intelligent every bit as much as they do to the average person. They apply to so called "experts" as well as non-experts. The best in their fields are aware of these errors and take measures to combat them. The book is a about Misdiagnosis not Medical Errors. Medical Errors are just systemic screw ups such as a hospital giving a drug to the wrong patient. (Actually, good progress is being made to eliminate these mistakes. For example, I walked into a hospital for an ultra sound and got one of those plastic wrist bracelets even though I was a fully conscious mobile outpatient. The bracelet was checked against the records and as well as I was asked my name and birthdate by the medical technicians.) Mis-diagnosis, is an error committed by the doctor when (s)he goes through the mental process to narrow down the patient's symptoms to a specific treatable disease and this process is where serious cognitive errors can arise. IF your diagnosis wrong, at best you will only continue to suffer, at worst, such as an incorrect cancer diagnosis, they can kill you!

One of my motivations for reading the book is, after years of swearing that I was NOT going to get back surgery, I am actually taking to surgeons. My condition is better defined then most "lower back pain" and its correction should NOT require the ever popular, often failed, spinal fusion. Interestingly, one chapter of the book does go into this huge industry of spinal fusions and largely confirms what I have read, i.e. that they usually fail to achieve symptom relief even when the operation is deemed to be a technical "success".

Other then the entertainment value, the book is intended to alert the patient (and friends and family) to be on the look out for signs your doctor may have erred in his diagnosis and offers you some tools to help your doctor get unstuck from a potentially incorrect initial diagnosis. The book explains that doctors are trained in formal "decision trees", yet no practicing doctors (after they finish their internship) uses them. Instead they use "pattern recognition". This especially is true for Emergency Room doctors which don't have the luxury of time. Questions like: "What else could it be?" or "What is the worst thing it could be?" are offered to get your doctor to go back to first principles and re-examine his "gut reaction" that he formed early during your first talk with him about the source of your current problem. ( )
  RFBrost | Nov 2, 2017 |
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Anne Dodge had lost count of all the doctors she had seen over the past fifteen years. She guessed it was close to thirty. Now, two days after Christmas 2004, on a surprisingly mild morning, she driving again into Boston to see yet another physician. (Introduction)
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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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