How Doctors Think

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.

"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 sage, humane prescription for medical practitioners and the people who depend of them." O, The Oprah Magazine

"A cogent analysis of all the wrong ways his fellow practitioners are trained to approach the patients they treat." Elle

"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....You’ll 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.

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.

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.

Introduction 1 1. Flesh-and-Blood Decision-Making 27 2. Lessons from the Heart 41 3. Spinning Plates 59 4. Gatekeepers 77 5. A New Mothers 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 Patients Questions 260

Acknowledgments 271 Notes 274 Index 292