How Doctors Think

In his latest book, How Doctors Think, Dr. Groopman, a haematologist affiliated with Harvard Medical School, takes the readers on a tour of a wide range of medical fields while jumping swiftly back-and-forth between the physician and the patient's perspective. Most chapters open with the story of an individual patient and his doctor, whose interactions introduce us to an aspect of problem-solving in medicine. The author then further expands upon the subject in an essay form by weaving into the story-telling opinions from experts of cognitive thinking in medicine as well as evidence from recent research work on the topic. The stories, although slightly melodramatic at times with their predictable climax followed by a happily-ever-after resolution, do provide an accurate and helpful glimpse of the complex infrastructures of health care to those unfamiliar with the field. Dr. Groopman possesses a quite impressive ability for stripping medical facts of their jargon and rendering them accessible to laymen. Each story directs his lens onto particular " cognitive errors " in the practice of medicine, a term he uses to describe flaws in the thinking of physicians that result in misdiagnosis and/or mismanagement of illnesses. Then, deftly alternating the focus between the analysis and the story, he intertwines theory and practice to demonstrate how these mental traps can be averted. A common belief among the general public, fuelled by popular entertainment media, unreservedly equates advanced technology with better medical care. Although health care providers attempt to show a bit more discernment toward the magnetic attraction of technology, we nevertheless find ourselves engulfed by this tornado of armamentarium that allows us to see deeper and smaller into the human body. Certainly, new technology is not portent of the downfall of medicine, on the contrary. But Dr. Groopman guards us against the looming danger of relegating to the back row the time-old skills of speaking and listening to the patient in favour of simply relying on faster and easier tests in making a diagnosis. Example after example, he highlights the risk of overlooking important subtleties, nuances and ambiguities in a patient's illness if we are not tuned in to their speech, their body language, their personal background. In a similar argument, he calls upon our caution in facing the increasingly influential presence of algorithms and guidelines in clinical practice. He asserts that these recipe-like approaches lead to cognitive errors in hindering creativity and flexibility of …