How Doc­tors Think

Jerome Groop­man
  • Review
By – March 26, 2012

The life of the 21st cen­tu­ry doc­tor has grown ever more hec­tic. There are increased mal­prac­tice wor­ries, insur­ance has­sles, reim­burse­ment cut­backs, and an over­all empha­sis to do more for patients with less time and few­er resources. Because of these exter­nal pres­sures, physi­cians may be more prone to diag­nos­tic errors. Most of the time, the cor­rect diag­no­sis is reached, but at impor­tant junc­tions, doc­tors may reach an erro­neous con­clu­sion, lead­ing to an adverse outcome. 

In his most recent book, How Doc­tors Think, Dr. Jerome Groop­man offers insight into how med­ical deci­sions are made. Using case his­to­ries, Groop­man enlight­ens on how physi­cians think in real time, the thought process­es involved, and how as a patient the read­er can help the physi­cian arrive at the cor­rect diag­no­sis. The read­er is shown how doc­tors make mis­takes, either by mak­ing snap judg­ments, hav­ing inad­e­quate infor­ma­tion, or ignor­ing impor­tant diag­nos­tic clues. The book also shows how patients can get the most out of their encoun­ters with their physi­cian, by ask­ing intel­li­gent ques­tions, accu­rate­ly describ­ing all their symp­toms, and tak­ing an inter­ac­tive role in their med­ical care. 

It seems that as the author encour­ages the patient to par­tic­i­pate in his/​her own care, and the physi­cian to take extra time so as to not make a mis­take, he is extend­ing a con­cept from a Mish­na from Hil­lel: A bash­ful per­son can­not learn, and a quick, impa­tient per­son can­not teach.”

Paul M. Arnold, MD, is pro­fes­sor of neu­ro­surgery and direc­tor of the Spinal Cord Injury Cen­ter at the Uni­ver­si­ty of Kansas.

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