How Doctors Think by Jerome Groopman Summary and Reviews
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Book Reviews of How Doctors Think
Book Review: Well worth reading and surprisingly enjoyable
Summary: 4 Stars
Sir Arthur Conan Doyle modeled Sherlock Holmes on the way that physicians use limited clues to diagnose illness. I don't know if he was aware that they tend to be wrong about 15% of the time. Dr. Groopman provides a fascinating study of why they go wrong, why they get it right, and how the patient can help with his own treatment. Well worth reading and surprisingly enjoyable.Book Review: Interesting but of limited practical help
Summary: 3 Stars
Groopman's book is inspiring and engaging, but most of it does not teach what the title says it will. Instead, most of the book tells how several physicians diagnosed or failed to diagnose correctly some difficult cases.
Groopman's useful advice to the general public consists of this recipe: (a) try to tell a physician what the problem is, (b) if the physician does not seem to understand, object and try again, and (c) if that still doesn't work, find another physician.
Groopman does not seem to understand that his advice fits, at best, those patients who have the time and the resources to spend, who have or strive to acquire significant medical knowledge, who are sufficiently assertive to carry out the recipe, and who somehow can access multiple physicians in a particular specialty. Coming from an elite background and living in an elite community, Groopman likely encounters many such people, but they are really a very small fraction of the general public.
Book Review: An excellent book that explains what goes on in the minds of doctors and their patients
Summary: 5 Stars
I purchased both the book and the audio CD. After listening to the CD I circulated an e - mail to my friends saying : " Everybody ought to read How Doctors Think by Dr. Jerome E. Groopman. Read it whether you are a doctor or not. As a doctor or as a patient you may have experienced similar unfortunate events explained in the book. In that case read the book to never go through the same events. If you have not gone through such experiences read the book so that you will never have to suffer from similar inconveniences."
Although a recent book "How doctors think " by Dr. Jerome E Groopman of Harvard Medical School has already caught a lot of attention and has been translated to different languages and is being sold in various countries. I am not a doctor. As patients my family and I have had to resort to the services of doctors many times. Not necessarily for big illnesses, sometimes only for check ups. In general we are quite healthy. I was attracted by the title of the book. Dr. Groopman explains very clearly what goes on in the minds of both the doctors and their patients and how their thinking styles affect their communication, the diagnoses and treatments. He gives many examples from many different branches of medicine. Everybody would agree with the assertion that better communication between patients and doctors is necessary. But how ? It is the how that Dr. Groopman explains. He shows the flawed thinking patterns in many doctors' thinking with actual detailed case studies leading to wrong diagnoses and treatments and how the doctor's thinking and reasoning should have been in each case. He says that some doctors jump to conclusions when they find a possible cause for a malady without searching for alternative causes that maybe more likely. He proposes a thinking method which generates many alternative explanations and working through the most likely ones before reaching a conclusion. This method seemed to me very similar to some of the correct thinking methods explained by a leading authority on the thinking subject : Dr. Edward de Bono.
Another issue that Dr. Groopman emphasizes is the need for better listening skills for doctors. On the average they interrupt their patients 18 seconds after they start to talk and often miss out on important information that maybe crucial for a correct diagnosis. As a patient I can not agree more. Patients also have a responsibility in effective communication but I think doctors have the upper hand in this matter so doctors need to read this book more carefully than patients. In my experience the doctors' interruptions can sometimes be very rude : several years ago I went to an ear, nose, throat specialist with an ear ache. After inspection he told me I had a certain kind of ear infection. I wanted to express my thoughts on the disease and said : " Doctor, as far as I know about this infection..." He abruptly interrupted and said : " Let's not deal with his infection with what you know about it but rather with what we doctors know about it ". In another case, my family and I had gone to a summer holiday village for vacation. The air temperature dropped for several days and half of the hundreds of tourists including us in the holiday resort began to cough and have fevers. I phoned the holiday camp doctor from our room and said : " Good day doctor. My family and I are coughing with a fever. Half the tourists in the resort are also. The weather is so cold. There seems to be a flu epidemic. Do you think it is a viral or bacterial infection ? " He replied : " Are you a medical expert ? I am the doctor around here and I am the best judge. I say there is no epidemic. People can get ill that is normal ".
In his book Dr. Groopman, in my opinion correctly says that there is no 100 % certainty in medicine. Even the most competent doctors can make wrong diagnoses. If the frequency of mistakes is too high then we can conclude the incompetence of the doctor. This may sound like stating the obvious but Dr. Groopman further states that despite the remarkable advances in medical technology such as brain imaging techniques etc. some doctors using these can still make the wrong diagnoses not because they are incompetent but because some of them see their patients as statistics or case studies not as real human beings. They fail to understand them as human beings. Dr. Groopman talks about the wrong thinking methods here. However, as a patient I would like to add that some doctors also have bad intentions. Most doctors I dealt with were honest and helpful, but I also came across in psychiatry several who had bad intentions. I have personally seen the improper utilization of advanced knowledge and technology : in psychiatry Quantitive EEG of the brain, questionnaires filled out by the patients such as the Beck Depression Inventory, The Beck Anxiety Scale, The Obsessive Compulsive Disorder questionnaire, the Minnesota Personality Test etc. are powerful tools at the disposal of a pychiatrist to help him / her diagnose, provided that they are properly evaluated. After these tests were implemented, I understood from the very superficial and wrong comments made by the psychiatrist that he had not carefully analyzed the tests and questionnaires. He did not understand us better after those tests. It is not the tests that were wrong, they could have been very useful had he taken the time to analyze them properly. Then why did he order these tests and the QEEG ? Because the hospital charges the patients for all those tests. They make money from the tests. I would not regret paying for them had they been properly evaluated.
As patients we have the responsibility to properly listen and implement our doctors' instructions such as taking the medications given in the right doses,times and durations, stop smoking and using substances, do the exercises and diet given by the doctors. But the doctors have to listen to us first. Our primary responsibility as patients is to find doctors who not only think correctly most of the time but who are also honest and competent.
In his book Dr. Groopman explains how smart patients can proactively participate in their dignoses by guiding doctors' thinking with relevant questions such as " could it be anything else ? ". If the doctor feels insulted or annoyed by such questions from the patient,as was in my case, then go to another doctor until you find one who does not feel insulted by relevant patient questions. This is perhaps esspecially needed in psychiatry : there are many competent psychiatrists but many others wrongly prescribe psychiatric medication or start irrelevant psychotherapies for what turns out to be physical illnesses that mimic the symptoms of a psychiatric disorder. The irresponsible psychiatrist overlooks it because he / she does not consider the possibility of a somatic illness by ordering blood tests. In such situations Dr. Groopman's advice to patients to ask " Could it be anything else ? " to their doctors is most relevant.
Thank you Dr. Jerome E Groopman for writing a much needed book. I hope many doctors and patients around the world will read it and revise their approaches towards communication with one another.
Book Review: Thinking About Thinking
Summary: 5 Stars
I've been doing a lot of speaking for the health care industry so How Doctors Think seemed like a good read for me. Indeed, the book is a fascinating look at how doctors and the rest of us process information and make decisions.
Doctors, like us mortals, learn best from making mistakes, but when docs make mistakes, people can die. Still, busy physicians use good old, pattern recognition to make educated guesses. They often use shortcuts known as heuristics. The "ABCs" of medicine, for example, are a type of heuristic (Airway, Breathing and Circulation).
Groopman contends that doctors and all of us do well to achieve "productive anxiety" as demonstrated by the Yerkes-Dodson Law. It's such a thin line between a heightened awareness and panic, eh?
Special kudos to the author for outing certain physicians who have committed serious errors in judgment.
Book Review: Dr. Merilind
Summary: 5 Stars
Very interesting book, that will open the other side of medical thinking. Very useful for doctors and for patients.