Sunday, November 30, 2008

"How Doctors Think"

I love highlighters. And I adore those tiny sticky strips with which I mark interesting passages in the books I read. So imagine my delight when a well-known pharmaceutical company via their local sales rep gave me four highlighters, each with scores of matching sticky tabs bursting out the sides. Of course, all these freebie pens bore the branded name of an expensive, widely-advertised anti-depressant.

Before I get to my point here, let me assure you that these gifts in no way influenced my prescribing habits. The pens, in fact, were all dried-up and hopeless for highlighting, but that made me no less likely to dole out the drug. The tabs were all I could hope for, but I promise you I've written not one additional prescription based on my delight. My patients often do well on this med, and that makes me more likely to prescribe it. Many who love the mood boost stop taking it, however, due to intolerable side effects, and that makes me less likely to write for it.

So there's a little insight into how this doctor thinks, but what I'm really plugging here is Dr. Jerome Groopman's must-have book "How Doctors Think." I'm halfway through it, and pages read thus far bristle with my ill-gotten, dirty-drug-money sticky tabs, each one flagging a point I wish I'd made in a book I wish I'd written. Not only should doctors read this book to understand why we think the way we do or to change our cognitive strategies in useful ways, you and I as patients (or as people who love and support patients*) should pay close attention as well.

Regular readers know that I've spent more than a little time these past two years as a designated listener and an advocate for friends and family working their way through the medical maze. I've seen how my colleagues listen or don't, and how they arrive at outrageous conclusions...or good ones, and the ways in which doctor/patient interactions influence the outcomes. Dr. Groopman has lots to say on the subject; more to come in later posts.
*Two other excellent books that will help you become your own best advocate are Sick Girl Speaks and Pursued by a Bear.

1 comment:

Bianca Castafiore said...

Now I know what to ask for this Christmas, thanks!

I have been a huge fan of Dr. Groopman, based on his New Yorker pieces -- specifically, his article about CRPS/RSD in Oct.
2005: "When Pain Remains."

Have you read "The Anatomy of Hope: How People Prevail in the Face of Illness"?