2009.11.29 02:33
If you have not, It is a New York Times Bestseller. "How Doctors Think" is a window into the mind of .... from the cover of the book Once I started reading this book, I couldn't drop it. |
2009.11.29 15:28
2009.12.01 08:04
2009.12.02 00:18
".... Doctors should think in sync with the patient.
The patient should be helped to think in sync with the doctors."
"There is nothing in biology or medicine that is so complicated that,
if explained in clear and simple language, cannot be understood
by any layperson. It's not quantum physics."
2009.12.03 04:17
".... Instead of informed consent, an informed choice - a comprehensive understanding
of all the options and their possible risks and benefits should be considered by the doctor,
the patient and the family. Informed choice means, in part, learning how different doctors
think about a particular medical problem and how science, tradition, financial incentives,
and personal bias mold that thinking. There is no single source for all of this information
about each disorder, so a patient and family should ask the doctor whether a proposed
treatment is standard or whether different specialists recommend different approaches,
and why. They also should inquire about how time-tested a new treatment is. "
".... Just because you can't treat someone any longer for his cancer doesn't mean that
you stop treating him. In fact, it is at this stage that treatment can be most challenging:
so narcotizing a person that he is unaware of his surroundings and unable to communicate
with loved ones; how to give of words of comfort while speaking the truth,
acknowledging that while the end is approaching, THE PERSON CAN STILL MAKE A
DIFFERENCE IN THE LIVES OF OTHERS."
2009.12.03 08:48
There are three cardinal pitfalls that lead to doctors' misdiagnosis.
The first is "anchoring error," anchoring on his first impression or diagnosis, and
shutting out other possibilities.
The second is "an attribution error," stereotyping the patient such as "a complainer or hypochondriac
or saying it's all stress-related and so on."
The third is "an availability error," by thinking that I've seen patients like this recently, etc.
The way the doctor and the patient avoid these errors are asking the following questions.
"What else can it be?" which should prompt the doctor to pause, think again and extricate
himself from a cognitive trap.
"Could two things be going on to explain my problem?"
This question avoids the pitfall of "satisfaction of search." In other words, the physician stops
looking for other causes as soon as he finds one cause even if the patient is having a persistent symptom.
This question will avoid that trap.
"Is there anything in history, physical exam or lab tests that seems to be at odds with the
working diagnosis?"
This question is an important safeguard against confirmation bias.
.... "from the book"
I have put on some lines from the book. However, the book certainly deserved to be
"best seller" because it already has contributed immensely in helping doctors and the patients
wake up to be better doctors and patients in every aspect since its publication in 2008.
Glad to know that people pay attention to doctors. That's why there is a book like this.
I have yet to see a book, named as "How lawyers think or How politicians think?"
Whatever doctors do must be regarded to be very important by the people who are not doctors.
But do Medicare, Insurance companies, politicians, or lawyers see us in the same light?
Nay... Nada... They don't see us like that.
People expect us to be precious, prestigious, and perfect;
but the guys who pay us see our group providing only very cheap labor !!
So, we get a lot of stress to be what is expected, but we hardly get paid for the trouble.
In the mean time, people generally consider lawyers, politicians, and stock brokers as scumbags,
yet people would gladly reward them with a bunch of money and praises anytime.
Why do I take an example with the lowly and rubbish "money"?
Because, not like the ancient times when the virtue was the prima donna of the society,
in this "modern" capitalistic society, the money equals the stature or the respect one commands.
Has Dr. Jerome Groopman ever mentioned something of this nature in his book?
I didn't read the book but I guess he hasn't.
If he hasn't paid attention to this aspect, may I dare to say that it may not be a good book?