Free eBooks Your Medical Mind: How To Decide What Is Right For You Available To Downloads
An entirely new way to make the best medical decisions.Making the right medical decisions is harder than ever. We are overwhelmed by information from all sides—whether our doctors’ recommendations, dissenting experts, confusing statistics, or testimonials on the Internet. Now Doctors Groopman and Hartzband reveal that each of us has a “medical mind,” a highly individual approach to weighing the risks and benefits of treatments. Are you a minimalist or a maximalist, a believer or a doubter, do you look for natural healing or the latest technology? The authors weave vivid narratives of real patients with insights from recent research to demonstrate the power of the medical mind. After reading this groundbreaking book, you will know how to arrive at choices that serve you best.
File Size: 751 KB
Print Length: 321 pages
Publisher: Penguin Books; Reprint edition (September 20, 2011)
Publication Date: September 20, 2011
Sold by: Penguin Group (USA) LLC
Language: English
ASIN: B0054TVW68
Text-to-Speech: Enabled
X-Ray: Not Enabled
Word Wise: Not Enabled
Lending: Not Enabled
Enhanced Typesetting: Enabled
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I looked forward to reading Dr. Jerome Groopman's new book, Your Medical Mind - How to Decide What is Right For You, co-authored with Dr. Pamela Hartzband. His previous work, How Doctors Think, shaped my thinking as a practicing primary care doctor on the importance of language and the potential pitfalls we make in reaching decisions. I always recommend my medical students read that book.Unfortunately, his latest work fell quite short of my expectations. In it, the authors try to understand and create a framework on how patients reach decisions about their medical care. In the end, this was a book about human psychology wrapped in the doctor patient relationship. Nothing particularly earth shattering here.The real question I had is who is responsible for helping patients avoid these cognitive and psychological errors? Patients or doctors?They note how the mindset of patients can be divided into the following categories - "believers and doubters; maximalists and minimalists; a naturalism orientation or a technology orientation." Specifically, some patients want maximal treatment and others believe "less is more". To avoid cognitive traps, the authors recommend that data be viewed in both positive and negative forms. Telling a patient that a therapy has side effects for 10 percent of patients is very different than saying 90 percent of patients have no side effects.Other tips to good decision-making included minimizing emotion before deciding, bringing a friend or family member to an appointment to provide additional eyes and ears, and also getting second opinions. Finding a doctor who provides "shared medical decision making" might also decrease the chance of making a choice only to regret it later.
This book explores medical decision-making and emphasizes the role of various biases that affect our decisions, usually unconsciously. Overall, it's a pretty good book and I can recommend it, but it's somewhat heavy on narratives of case histories and light on systematic presentation of the key findings - basically opposite of a textbook and apparently targeted more at the general reader.I personally would have preferred a more systematic presentation, but I went ahead and compiled my own summary of the key findings:(1) In general, the findings described in the book apply to everyone involved in making medical decisions: patients, patient advocates, physicians, nurses, researchers, administrators, etc.(2) Our backgrounds predispose us towards taking varying general approaches to making decisions, such as being a minimalist (as little treatment as possible, letting the body primarily take care of itself), maximalist (treating aggressively, including treating preventively), naturalist (favoring natural CAM treatments rather than conventional allopathic medicine), technocrat (favoring modern high-tech medicine), and pragmatist (choosing from the whole range of treatment options as each particular situation warrants).(3) The way information is framed can greatly influence our decisions. For example, "40% of patients are cured by this treatment" sounds more encouraging than "this treatment fails to cure 60% of patients." An implication is that statistics for treatment outcomes have to be looked at carefully, and looking at only summaries of statistics can be misleading.(4) Anecdotal cases (as reported in this book) can be informative, but they can also excessively influence our decisions (availability bias).
This book addresses the issue of how we make decisions about our medical care. Most of the book is comprised of case studies, actual patients who had to make decisions like whether to take cholesterol-lowering drugs, have knee surgery or sign do-not-resuscitate orders.Drs. Groopman and Hartzband let the patients talk at length. Their stories are not simple tales with black-and-white answers or outcomes. The patients dither, they procrastinate, they clam up when they should talk frankly, they change their minds, they reject medical advice. Sometimes they do the right thing, sometimes they don't.I appreciated this ambiguity. We often read medical horror stories and think, "Well, I wouldn't have made a mess of it like they did. I would have done the right thing." These stories show that the right course of action is often not clear or straightforward, and even when it is, it may be a difficult action to take, for many reasons.Drs. Groopman and Hartzband do a fine job of identifying ways patients typically respond to medical advice, especially in the concluding chapter. You can skip right to that one, if you want: some people are believers, some doubters, some trust in natural therapies, some in technology, some people are minimalists, others maximalists. Most of us harbor some mix of these tendencies that guides our medical decision making.I'm not sure the book addresses "how to decide what is right for you" as the subtitle suggests. I found the book to be more descriptive than prescriptive. And, I suspect that when most of us become patients we won't have the same luxury to weigh options and come to reasoned conclusions as the people in this book did. After a while, I just wanted to shout at some of these folks, "Take the pill! Have the surgery!
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