A fascinating book was published by Dr. Jerome Groopman titled How Doctors Think. The purpose of this book is to show doctors and especially patients how physicians are taught to diagnose medical conditions and how they actually do it in practice. To get a copy of the book, here’s a link to the Amazon order page.
Dr. Groopman, in his book, clarifies that there is a difference in medical errors caused by technical and administrative error and the problem of misdiagnosis. Medical error of the technical or administrative sort would be problems like reading an x-ray backward, operating on the wrong limb, or administering medication incorrectly because someone read a prescription wrong. The misdiagnosis problem leading to medical malpractice that Dr. Groopman discusses in his book has more to do with how doctors fail to think clearly and accurately about the patient presenting before them. Essentially, the book is about how things like a doctors emotions can cause a mistake in diagnosis.
For example, if a doctor really likes a patient, he may be hesitant to do an invasive procedure which may cause that patient pain or discomfort. Likewise, if a doctor really doesn’t like the patient, for example thinks they are chronic drunk who is failing to take care of himself, they may stop listening and treating the patient’s problems as real. Other mental errors that the doctor discusses in his book are jumping too quickly to a decision about what is wrong with the patient without considering things other than what may be most likely, thereby missing a more unusual but potentially catastrophic medical problem.
One thing I liked about the book is how it shows patients how they can potentially help their doctors to avoid mental mistakes leading to misdiagnosis. For example, the author recommends that when you are with your doctor you should ask them, “what is the worst thing that this could be?” This question if asked in a respectful way could cause the doctor to pull back and consider other parts of a differential diagnosis with more serious outcomes rather than fail to think about all possibilities.
Dr. Groopman, in his book, also said that if you do not think your doctor likes you, then he would recommend changing physicians. When the doctor does not want to deal with you for whatever reason, he is probably not thinking about your medical situation as clearly and unemotionally as he needs to.
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