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How Doctors Think | [Jerome Groopman]

How Doctors Think

On average, a physician will interrupt a patient describing her symptoms within 12 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.
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Publisher's Summary

A New Yorker staff writer, best-selling 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.

On average, a physician will interrupt a patient describing her symptoms within 12 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.

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 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 21st-century medical practice, giving doctors and patients the vital information they need to make better judgments together.

©2007 Jerome Groopman, M.D.; (P)2007 Tantor Media Inc.

What the Critics Say

"A revealing, often disturbing look at what goes on in doctors' minds when treating patients....A highly pleasurable must-read. "(Kirkus)
"I wish I had read this book when I was in medical school, and I'm glad I've read it now....Every reflective doctor will learn from this book....every prospective patient will find thoughtful advice for communicating successfully." (Publishers Weekly)

What Members Say

Average Customer Rating

3.8 (383 )
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  •  
    Audiophile Baltimore, MD USA 05-13-07
    Audiophile Baltimore, MD USA 05-13-07 Member Since 2005
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    "Disappointing"

    I enjoy Groopman's articles in the New Yorker, and I took this selection after hearing his compelling interview on NPR. However, I was disappointed in the content of the book. This does not really tell us too much about how doctors think; what constitutes the complexity of a diagnosis or how doctors make decisions. Rather, it is more of a collection of stories about misdiagnosis or mistreatment of patients and friends of Dr. Groopman. And it turns out that Groopman is mostly the hero of the book -- either making the tough diagnosis himself or referring to one of his friends who saves the day. His friends happen to be located at Harvard, Mayo Clinic, and Sloan-Kettering. Not exactly the answer for the masses of Americans belonging to HMOs who cannot even get a specialty referral without a letter to a congressman.

    The book starts out addressing the theme that young doctors are becoming too entranced with algorithmic medicine. He complains that they follow guidelines for care like robots on an assembly line. Most would agree, however, that the bigger problem in American medical care is the failure of doctors to adhere to evidence-based guidelines, rather than over-reliance on them. Care for diabetics, asthmatics, and hypertensives fall far short of what it should be and what would improve the health of the nation.

    Dr. Groopman does share our pain, however. He had a day of distress because a doctor called him at home with a fatal mis-diagnosis while his wife was away skiing. He had the diagnosis corrected the next day at work, but lost a night's sleep over it.

    Once you get past the self-congratulations, the old-boy network of super-docs, the confessions of imperfection in himself, and the self-pity; there are a few good points.
    1. Get a second opinion.
    2. Be an informed consumer.
    3. Ask questions
    3. If you do not like your doctor, get another one.
    Not worth the read to learn these lessons.;

    31 of 32 people found this review helpful
  •  
    Christine Darnestown, MD, USA 09-03-07
    Christine Darnestown, MD, USA 09-03-07 Member Since 2007
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    "Very informative"

    This book provides a fascinating insight into medical decision making in the absence of hard evidence and lives at stake. At the end of the book, I definitely had a much better feel for what doctors could reasonably know when making diagnoses and decide on treatment and how difficult it must be to recommend paths forward for medical interventions. One thing I definitely took away from this book is that doctors are not all-knowing and when in doubt, do get a second opinion even if it is just to get a sense of how differing opinions about a certain condition really are...
    Great book, I have already recommended it to many of my friends and colleages as a "must read".

    11 of 11 people found this review helpful
  •  
    Robert Yamhill, OR, United States 12-18-09
    Robert Yamhill, OR, United States 12-18-09 Member Since 2009

    Hey Audible, don't raise prices and I promise to buy lots more books.

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    "How Doctors Think"

    Any health-care provider will greatly benefit from reading and applying the gems in this book. As a result, so will our patients. It is excellent in its science, its logic and its writing.

    5 of 5 people found this review helpful
  •  
    Michael Providence, RI, United States 08-07-09
    Michael Providence, RI, United States 08-07-09 Member Since 2004
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    "Terrible narration, great idea, good execution"

    To begin with, the narration was horrible. I am a doctor and had looked forward to this book with great enthusiasm. However the narrator's dry, business-like narration sounded like the worst stereotype of a condescending paternalistic doctor one could imagine. But to make things worse he frequently and repeatedly mispronounced medical terms. How hard would it have been to make a list of terms he did not recognize and ask Groopman how to say them?

    As far as the book goes, it was generally excellent, and I have found it very instrumental in guiding my own thinking and avoiding mistakes. There were some sections that were silly, for example there is a section in which his fellow temple congregant, a mother named Rachel, underwent an ordeal in which a child she adopted got very sick. He spent way too much time on this chapter and focused, nearly obsessively, on her religious reflections which did nothing to advance the points he was making.
    At other times he was repetitious. For the most part, however, this was an exhilarating and a refreshing way to look at medical errors and medical decision making, and is getting the attention it more than deserves from medical circles.

    8 of 9 people found this review helpful
  •  
    Paul San Francisco, CA, USA 06-05-07
    Paul San Francisco, CA, USA 06-05-07 Member Since 2004
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    "Totally flat reader"

    I really enjoy Jerome Groopman's columns in the New Yorker, but the book made him seem stiff, repetitive, and pompous. All the observations seemed trite and obvious and none of his case studies held my interest for their length. Even worse, the reader read everything in a flat monotone, reminiscent of a 1950s educational tape (e.g., "Your Friend, Aluminum"). Do not attempt this book while driving -- your mind will wander and you will fall asleep.

    The best parts of the book are Groopman's discussing his own (rather than other doctors') experiences; particularly interesting was his description of his article on Cox-2 inhibitors, which kicked off much of the enthusiasm for those drugs in the US.

    12 of 14 people found this review helpful
  •  
    Douglas Auburn, WA, United States 11-11-12
    Douglas Auburn, WA, United States 11-11-12 Member Since 2008

    College English professor who loves classic literature, psychology, neurology and hates pop trash like Twilight and Fifty Shades of Grey.

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    "Thoughtful..."

    reminiscent of the work of the great surgeon Richard Selzer, Groopman's work gives the reader a wonderful insight into the ways that a doctor thinks, both when he makes the right decision regarding a patient--and when he makes a wrong one. He reminds us of what real critical thinking is--being at once calculating and creative in a realm in which uncertainty reigns.

    2 of 2 people found this review helpful
  •  
    L New York, NY, United States 01-13-09
    L New York, NY, United States 01-13-09 Member Since 2005
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    "How Emotion and Perception Affect Your Care"

    Doctors are human, just like us. And if you care about your health and want to get good health care results, it pays to remember this. The book is interesting and informative, with fascinating anecdotes, and provides useful insight, looking through the eyes of doctors.

    4 of 5 people found this review helpful
  •  
    Thomas Tonkin Castle Rock, CO United States 01-24-14
    Thomas Tonkin Castle Rock, CO United States 01-24-14 Member Since 2013

    Sincerity in Leadership. Sales Enablement and Performance. Speaker and Author. But what I realIy do is help people be the best they can be.

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    "I listened and liked it, but not why you think."
    What did you love best about How Doctors Think?

    I picked this book up because Tom Peters referenced it when he was discussing leaders as doctors, or problem solvers. I read it from a sales person's perspective and found some great parallels. I am a sales enablement person by day and now use stories and points made in this book in my training sessions. Good book overall.


    0 of 0 people found this review helpful
  •  
    Geoffrey Lafayette, CA, United States 04-11-09
    Geoffrey Lafayette, CA, United States 04-11-09 Member Since 2009
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    "Boring"

    Really boring and mistaken in many assumptions. Its not that doctors don't think of an unusual disease (such as Wilson's disease) every time a drunk enters the ER, its that payers will not approve exotic tests on every patient. We could practice medicine to never miss a diagnosis but at a staggering cost that society is not willing to pay for. Any episode of "House" is a better insight into how doctors think.

    6 of 14 people found this review helpful
  •  
    David Austin, TX, USA 06-17-07
    David Austin, TX, USA 06-17-07 Member Since 2001
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    "And why you need to be thinking as well"

    A great book for everyone to read as it illustrates, as the author states, that a patient has to be an active participant in the process of seeking the care and treatment one needs.

    4 of 10 people found this review helpful
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