I started a post on this book about a week ago and it seems to have vanished off my hard drive. That’s fine with me, actually, because it was going nowhere fast, and I’m hoping I can do a better job this time.
Jerome Groopman, M.D. is a writer for The New Yorker (and has published several full-length books) as well as an oncologist. This book, like Being Mortal, was handed to me by my boss Cathy, and told I had to read it sooner than I read most of the other books she gives me (as everyone here knows, I’ve been averaging about four years between her giving me a book and me actually getting around to reading it lately), because EVERYONE, i.e. all of the veterinarians in our practice, needs to read this one. How Doctors Think was similar to Being Mortal in the sense that both are about how doctors and patients can do better at their jobs, but How Doctors Think honed in on the specifics of how doctors can screw up sometimes, and not because of how you’d think they would. It’s all about errors in cognition, and the mindsets we all get into about misreading patients, focusing too much on one set of diagnostic results over another, and things like that. It was not exactly easy reading, and it made me think hard about how I practice medicine, and made me second guess a lot of things I did while I was reading it, as well as since I read it. Which is good, I admit, but made me feel pretty angsty for a few days.
Because I finished this book over a month ago, I’m beginning to lose many of the details, and since I want to actually post something today, I’m not going to go digging through the text. Sorry, gang. It’s going to be a quick post. Groopman interviewed quite a few physicians from multiple different specialties for this book, and talked to them about cases where they felt they could have done better. The early chapters dealt specifically with the different cognition errors that medical folks can have, such as the “availability heuristic,” in which one makes a diagnosis because a case is similar to others that he or she has seen recently; “confirmation bias,” in which one selectively ignores or focuses on certain diagnostic information; and “anchoring,” in which one picks a diagnosis and sticks with it, even if additional data make the initial diagnosis seem less likely. Groopman goes through multiple specialties, discussing how each type of physician can make each sort of error, and there are quite a few medical anecdotes to keep things interesting.
Groopman intends this book to be for both doctors and patients, and makes recommendations how patients can help their doctors avoid these cognitive errors. Overall I really did think this book was IMPORTANT, and that people should read it, but it wasn’t always easy reading. Some of the stories were heart-wrenching in and of themselves, and others brought up memories of cases I’ve had that haven’t gone so well. I guess my recommendation is that people read this book, but that they read it when they are not in delicate frames of mind.
I like reading through your web site. Thanks a lot!