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How Doctors Think

Written by: Jerome Groopman M.D.
Narrated by: Michael Prichard
Length: 10 hrs and 27 mins
Categories: Science & Math, Medicine
4.5 out of 5 stars (7 ratings)

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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

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  • Overall
    5 out of 5 stars
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    5 out of 5 stars

Great book for physicians and patients

I’m an Emergency Physician and think that the concepts in this book are great for physicians to review and reflect on and for patients to know about. In Emergency Medicine we spend a lot of time learning and thinking about this material but reviewing it for any physician will not be time wasted.

For patients, knowing how physicians can err in their thinking and specific questions to ask is very useful.

My criticism of the book is that I think that it does tend toward doctor bashing a little bit. He recounts so many stories of missed diagnoses which is important for the book. But the fact is that most of the time a physician is correct and I think this book subtly and unconsciously encourages doctor shopping. Learn how to have transparent conversations with your doctor so that you can relay your values so that you can come to a treatment plan that works for you. If your doctor isn’t willing to do this then that’s a good reason to find a new doctor. Being a patient is not a passive thing, you play a critical role in getting the outcome that you want and aligns with your values.

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  • Overall
    3 out of 5 stars
  • Audiophile
  • 2007-05-13

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.;

44 of 46 people found this review helpful

  • Overall
    3 out of 5 stars
  • Michael
  • 2009-08-07

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.

14 of 15 people found this review helpful

  • Overall
    5 out of 5 stars
  • CFS
  • 2007-09-03

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".

12 of 13 people found this review helpful

  • Overall
    1 out of 5 stars
  • Paul
  • 2007-06-05

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.

14 of 16 people found this review helpful

  • Overall
    3 out of 5 stars
  • Performance
    2 out of 5 stars
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    4 out of 5 stars
  • Cathryn
  • 2015-09-25

Odd narration, good book

Is there anything you would change about this book?

I thought the writing was good and the content was very interesting. Many of the cognitive issues addressed apply to areas of life other than medicine, so I think I will be able to apply some of the lessons from this book, even though I am not a doctor. It will probably make me a better patient, too.

What didn’t you like about Michael Prichard’s performance?

His voice sounded like a 1950's TV doctor. It was a bit jarring at first, especially in contrast to the content of the book. If I revisit this book, I will probably switch to reading it, rather than listening.

3 of 3 people found this review helpful

  • Overall
    5 out of 5 stars
  • Robert
  • 2009-12-18

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 6 people found this review helpful

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    1 out of 5 stars
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    2 out of 5 stars
  • JSSL
  • 2018-10-04

Boring and Monotonous Narration

The book may be great, but the narration is boring, monotonous, and unengaging. I do not recommend.

1 of 1 people found this review helpful

  • Overall
    5 out of 5 stars
  • L
  • 2009-01-13

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.

5 of 7 people found this review helpful

  • Overall
    3 out of 5 stars
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    3 out of 5 stars
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    4 out of 5 stars
  • Jheesekindle
  • 2019-06-13

Good insight to medicine but...

Not every patient has the luxury of being in a physician marriage and seeking out five highly trained specialists and a sixth specialist to review the complicated choice of treatment. This is the epitome of doctor shopping.

Not every physician who spends their whole energy through the day and past 8pm is the model clinician. Not every physician who strives for a work-life balance is a failure to her or his patients.

I appreciate the deep discussion about uncertainty in medicine, cognitive errors, biases and heuristics. Thanks.

  • Overall
    4 out of 5 stars
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    4 out of 5 stars
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    4 out of 5 stars
  • Ryan Bernal
  • 2019-04-23

Definitely worth the listen!

Hear me out... the narrator is monotone and the book isn’t exactly captivating, BUT there is some very important lessons for future doctors. This is a non-technical book and in many ways is intended for the regular person so that they can be better equipped to communicate with their doctor and ensure their best medical care.