Synopses & Reviews
A New Yorker
staff writer, best-selling author, and professor at Harvard Medical School unravels the ultimate medical mystery: how doctors figure out the best treatments or fail to do so.
On average, a physician will interrupt a patient describing her symptoms within twelve 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. He 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 have a profound impact on our health. This book is the first to describe in detail the warning signs of erroneous medical thinking, offering 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 physicians, 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.
"I wish I had read this book when I was in medical school, and I'm glad I've read it now. Most readers will know Jerome Groopman from his essays in the New Yorker
, which take on a wide variety of complex medical conditions, evocatively communicating the tensions and emotions of both doctors and patients.But this book is something different: a sustained, incisive and sometimes agonized inquiry into the processes by which medical minds brilliant, experienced, highly erudite medical minds synthesize information and understand illness. How Doctors Think
is mostly about how these doctors get it right, and about why they sometimes get it wrong: "[m]ost errors are mistakes in thinking. And part of what causes these cognitive errors is our inner feelings, feelings we do not readily admit to and often don't realize." Attribution errors happen when a doctor's diagnostic cogitations are shaped by a particular stereotype. It can be negative: when five doctors fail to diagnose an endocrinologic tumor causing peculiar symptoms in "a persistently complaining, melodramatic menopausal woman who quite accurately describes herself as kooky." But positive feelings also get in the way; an emergency room doctor misses unstable angina in a forest ranger because "the ranger's physique and chiseled features reminded him of a young Clint Eastwood all strong associations with health and vigor." Other errors occur when a patient is irreversibly classified with a particular syndrome: "diagnosis momentum, like a boulder rolling down a mountain, gains enough force to crush anything in its way." The patient stories are told with Groopman's customary attention to character and emotion. And there is great care and concern for the epistemology of medical knowledge, and a sense of life-and-death urgency in analyzing the well-intentioned thought processes of the highly trained. I have never read elsewhere this kind of discussion of the ambiguities besetting the superspecialized the doctors on whom the rest of us depend: "Specialization in medicine confers a false sense of certainty." How Doctors Think
helped me understand my own thought processes and my colleagues' even as it left me chastened and dazzled by turns. Every reflective doctor will learn from this book and every prospective patient will find thoughtful advice for communicating successfully in the medical setting and getting better care. Many of the physicians Dr. Groopman writes about are visionaries and heroes; their diagnostic and therapeutic triumphs are astounding. And these are the doctors who are, like the author, willing to anatomize their own serious errors. This passionate honesty gives the book an immediacy and an eloquence that will resonate with anyone interested in medicine, science or the cruel beauties of those human endeavors which engage mortal stakes. (Mar. 19)Signature Review by Perri Klass. Klass is professor of journalism and pediatrics at NYU. Her most recent book is Every Mother Is a Daughter
, with Sheila Solomon Klass. Publishers Weekly (Starred Review)
(Copyright © Reed Business Information)
"Dr. Jerome Groopman is bringing out his most essential book yet, How Doctors Think." Boston Phoenix
"A highly pleasurable must-read." Kirkus Reviews, (Starred Review)
"A book to restore faith in an often-resented profession, well enough written to warrant its quarter-million first printing." Booklist
"A cogent analysis of all the wrong ways his fellow practitioners are trained to approach the patients they treat." Elle
"A sage, humane prescription for medical practitioners and the people who depend of them." O, The Oprah Magazine
"Splendid and courageous...Groopman lifts the veil on the most taboo topic...the pervasive nature of misdiagnosis." Ron Chernow, author of Alexander Hamilton
"Groopman has written a unique, important and wonderful book....Youll never look at your own doctor in the same way again." Steven D. Levitt and Stephen J. Dubner, authors of Freakonomics
A New Yorker staff writer, bestselling author, and professor at Harvard Medical School unravels the mystery of how doctors figure out the best treatments or fail to do so. This book describes the warning signs of flawed medical thinking and offers intelligent questions patients can ask.
The renowned Harvard Medical School physician and New Yorker writer Jerome Groopman presents an entirely new way of understanding medicine and medical care to give patients and their families insight into why some doctors succeed in thinking through problems and why some doctors fail. Dr. Groopman reveals the most common mistakes in doctors' thinking and tells patients how to engage in dialogue to help their doctors prevent misdiagnoses in treatment....It's a book for everyone who's ever been a patient. Even other doctors can't wait to read it.
How Doctors Think is a window into the mind of the physician and an insightful examination of the all-important relationship between doctors and their patients. In this myth-shattering work, Jerome Groopman explores the forces and thought processes behind the decisions doctors make. He pinpints why doctors succeed and why they err. Most important, Groopman shows when and how doctors can -- with our help -- avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health.
About the Author
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. He has published more than 150 scientific articles. He is also a staff writer at the New Yorker and has written editorials on policy issues for the New Republic, the Washington Post, and the New York Times.
Table of Contents
1. Flesh-and-Blood Decision-Making 27
2. Lessons from the Heart 41
3. Spinning Plates 59
4. Gatekeepers 77
5. A New Mother's Challenge 101
6. The Uncertainty of the Expert 132
7. Surgery and Satisfaction 156
8. The Eye of the Beholder 177
9. Marketing, Money, and Medical Decisions 203
10. In Service of the Soul 234
Epilogue: A Patient's Questions 260