The same shortcuts that help physicians save lives can also lead to grave errors. Jerome Groopman on the psychology of diagnosis. In this very engaging and well-researched book, Jerome Groopman, a practicing oncologist with expertise in AIDS-related malignancies. In the hands of Jerome Groopman, professor of medicine at Harvard and One of the messages of “How Doctors Think” is that patients need to.

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How Doctors Think by Jerome Groopman

Arrows branch from the first box to other boxes. Because doctors desperately need patients and their families and friends to help them think.

She grew up in a small town in Massachusetts, one of four sisters. We have all asked ourselves exactly what brought him to propose a certain diagnosis and a particular treatment and to reject the alternatives.

He proposed more blood tests, which were simple enough, but then suggested a procedure called an endoscopy. Several doctors and a pharmaceutical executive speak with great candor about the reach of drug marketing, about how natural aspects of aging are falsely made into diseases, and how patients can be alert to this.

The chapter “A New Mother’s Challenge” was probably one of the best examples of how and why doctors err and how the caregiver is oftentimes in the best position to solve the mystery. Your purchase helps support NPR programming. How Doctors Think is organized around a series of interviews of physicians mostly in a variety of medical specialties.

How a doctor thinks about a person or their opinion on someone can easily lead to a mistake in diagnosis or treatment.

May 29, P Chulhi rated it it was ok Shelves: The chapter “A New Mother’s Challenge” was probably one of the best examples of how and why doctors err and how t A must read for every doctor who practices medicine and for those patients who forget that doctors are practicing medicine and make errors in judgment and he explains why these mistakes are made in a very very entertaining way. How does a doctor think when he is forced to improvise, when confronted with a problem for which there is little or no precedent?

The team then returns to the conference room to discuss the problem. It then illustrates this with a bunch of stories of touching stories of First of all, I should say that I’m a doc.


The errors and the asute diagnoses are compiled in story after story. Medical school admissions committees no longer accept a record of gentlemen’s C’s at an Ivy League college. Falchuk said, “or that your weight loss is only due to bulimia and anorexia nervosa.

Tell me about when you first didn’t feel good. Each morning as rounds began, I watched the students and residents eye their algorithms and then invoke statistics from recent studies. Excellent and thoughtful book, but I subtracted one star for a minor problem: No one had had an illness like hers.

Rarely did an attending physician actually explain the mental steps that led him to his decisions. Can Jerome Groopman be my doctor? Then I searched the medical literature for studies of clinical thinking. Following each example of incorrect diagnosis there is an analysis of the reasons why the errors were made.

‘How Doctors Think’

He expounds on the cognitive pitfalls that might cause misguided care: He suggests that the poor reimbursement and lack of recognition for primary care physicians is fundamentally flawed. He takes phrases patients often hear, such as “we see this sometimes” and puts forth the idea that such generic comments deserve further questioning from the patients. Perhaps there’s something I forgot to mention. Groopman’s storytelling skill permits him to convey complex concepts e.

First, the story line of many of the anecdotes culminated in getting a test to finally arrive at the correct diagnosis, often at the insistence of a patient that more be done. We listen to all of the recommendations and weigh the evidence as best we can. The rest of the book, however, feels incomplete. Anne lost her appetite and had to force herself to eat; then she’d feel sick and quietly retreat to the bathroom to regurgitate.

Now, in the middle of my third year of medical school, I understand more about the process of arriving at a differential diagnosis and the book had significance to me in a way it did not before.

A bone marrow biopsy showed very few developing cells.

He argues that gatekeeper physicians are underreimbursed for their work, believing this to be a jeromee of the doctogs earlier this century when surgeons headed the medical societies that negotiated with insurers about what a ‘customary’ payment for services was to be. Falchuk is a compact man in his early sixties with a broad bald pate and lively eyes.


After surveying the significance of a doctor’s words and feelings, the book follows the path that we take when we move through today’s medical system.

How Doctors Think

Facebook Twitter Flipboard Email. This so-called evidence-based medicine is rapidly becoming the canon in many hospitals.

If you’re interested in the medical field at all or perhaps have had an illness that resisted easy diagnosisI definitely recommend it.

Half of all medical students are now female. Is there another physician or center that would have more insight into my problem? This is Bayesian analysis, a method of decision-making favored by those who construct algorithms and strictly adhere to evidence-based practice.

Specific chapters deal with errors in primary care, where you are looking for the one sick patient in the sea of healthy ones every day, to errors in very specific subspecialities such as pediatric cardiology, where we must not forget we are making some of this up as we go along, as each patient is unique and requires a specialized treatment plan.

And I think all doctors and aspiring hoow should read this book. Falchuk did something that caught Anne’s eye: By continuing to use our website, you are agreeing to our privacy policy. Primary Source How Doctors Think.

How Doctors Think | The Journal of the American Osteopathic Association

Groopman tells the story of a woman named Anne Dodge, who suffered from malnutrition. Using many examples of this sort, including some from his own life, Dr Groopman shows how prejudgments, groolman case loads, and other things can lead to erroneous thinking.

Today, medicine is not separate from money. According to one study cited by Groopman, some 80 percent of misdiagnoses could be attributed to a cascade of cognitive errors, not lack of medical knowledge. In a later chapter Groopman reports a frank discussion with Dr.