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How Doctors Think


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I was in Barnes and Noble this afternoon and saw a book on the bestsellers' shelf called "How Doctors Think," by Jerome Groopman. It's all about how doctors make their diagnoses, and the reasons for misdiagnoses, so seems to hit on the frustrations that many of us have with doctors. It sounds like it also offers the lessons that some of us have learned the hard way - to keep looking until you find the right doctor and to be proactive in your own care. I'm posting this in part because I thought it would be of interest to many of you and also because I'm curious to see if any of you have heard or read about it. I didn't buy it, but probably will soon.

Here are the first few paragraphs of the New York Times book review. The full review is at


"This elegant, tough-minded book recounts stories about how doctors and patients interact with one other. In the hands of Jerome Groopman, professor of medicine at Harvard and a staff writer for The New Yorker, these clinical episodes make absorbing reading and are often deeply affecting. At the same time, the author is commenting on some of the most profound problems facing modern medicine.

Groopman powerfully conveys the complexity of the physician?s role, the anxiety and uncertainty that dog his every step, the difficulties that arise in understanding patients, eliciting their stories, making a diagnosis. One of the messages of ?How Doctors Think? is that patients need to be active participants in their care; and without question the best physicians encourage, and even demand, the involvement of patients. Yet a paradox lies at the heart of Groopman?s subject: although the medical profession has long recognized that doctors communicate poorly with patients, physicians receive little training to improve that interaction. Historically, medical education has regarded communication skills with an indifference that approaches contempt. It?s unscientific, it?s hand-holding, it?s bedside manner. Yet it?s clearly important.

Groopman focuses on one aspect of the doctor-patient interaction: how it influences a physician?s diagnosis, and even his ability to make a diagnosis at all. His stories show us instances where a doctor makes snap judgments that are wrong ? and right; where past cases distort present perception; where rapport with, or dislike for, a patient alters diagnosis or care. (This leads Groopman to one of the few direct recommendations in this book: if you get the feeling your doctor doesn?t like you, find another one.)

Unlike such simple errors as prescribing the wrong dose of medicine or reversing an X-ray, Groopman writes, misdiagnosis is ?a window into the medical mind,? revealing ?why doctors fail to question their assumptions, why their thinking is sometimes closed or skewed, why they overlook the gaps in their knowledge.? According to one study he cites, as many as 15 percent of patients receive inaccurate diagnoses, a finding that matches research based on autopsies."

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I am literally sitting here reading a clipping(my cousin sent me)from Time Mag. , entitled "Where Doctors Go Wrong" It tells a little about Groopman's misdiagnosis of a friend's child. This started his journey of research and led to the book "How Doctors Think". I do think it would be interesting to us. Just this clip gives a few examples ,such as the doc does not like you, or just looks at your appearance,or your emotional state.

This article basically says this book should be a must read for any doc. who cares about his patients.

My sister works at a library,I am going to see if she can get it for me.


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Hey Rita!

Thanks for posting about that.

I heard it on NPR...and if you want to hear an interview with the doc or read an excerpt from the book, just go to www.npr.org and do a search for 'groopman' and the stories will come up. You can listen or read...

I meant to post it earlier, so thanks for posting!!!!!

Later alligator!


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