NPR interview and book excerpt from "How Doctors Think"

[Kyla]

http://www.npr.org/2007/03/16/8946558/groopman-the-doctors-in-but-is-he-listening

Interesting article on how doctors communicate with patients and vice-versa - and how this can lead to misdiagnoses. I haven't read the book, but the excerpt is interesting, and I think probably relevant to many here.

 

[helen1]

Would love to read this book; thanks for posting that link @Kyla.

 

[msf]

It reminds me of the famous chapter in the Natural History of Iceland, on Snakes in Iceland, which read: Snakes in Iceland; there aren´t any.

For some doctors a similar chapter would be appropriate: How some doctors think; they don´t.

 

[Mary]

What if other "professionals" acted the same way - got an idea in their heads based on very little evidence (e.g., the sound of someone's voice) and acted on it - e.g., lawyers, architects, engineers - they would be out of business so fast. Yet doctors are dealing with our lives and it's extremely discouraging to read about how doctors "think", for I don't call it thinking, when they refuse to look at evidence or to listen to their patients.

 

[jimells]

It's no surprise to me that doctors don't do much thinking. After all, every American is expected to spend at least a dozen years in the hands of an institution designed to discourage thinking. Americans seem to think that public education is "broken". They are unable to understand that the goal is to manufacture compliant workers who will think what they are told to think.

I have seen little indication that medical school is substantively different. Drug and device manufacturers certainly wouldn't want doctors to question the baloney being peddled by the companies.

 

[msf]

My friend made an interesting point about this recently, namely that quite a lot of medical school is based around the memorisation of facts, rather than theorising about how different facts might be related. This is for the very good reason that they have to be able to diagnose many different illnesses based on many different symptoms, but it is not a good base to build theories of a disease on. These theoretical skills are hopefully learnt by medical researchers in the course of their research, but it does mean that a lot of GPs and others who do not have a strong research background do not seem to be able to theorise in this way.

 

[alex3619]

it does mean that a lot of GPs and others who do not have a strong research background do not seem to be able to theorise in this way.

Researchers are definitely better at understanding complex cases in my view. The other thing I suggest to people with misunderstood conditions is to find a doctor with the same health issues as you have.

 

[msf]

What an indictment!

 

[Cheshire]

Another insight into drs' thinking:
http://drmalcolmkendrick.org/2015/05/10/medicine-science-or-religion/
(thanks to Suzy Chapman)

Primarily, it becomes extremely difficult for you, or the rest of the brotherhood, to admit that you don’t know something? Or that things you have been telling people, or doing, are in fact useless or wrong. Because if you start doing that, you fear you may lose your hard won authority, control and respect. Equally, if patients no longer believe, or trust in you, or your advice, what then? Fear stalks the land. Metaphorical skull crushing looms.

Additionally, if a doctor cannot discover what is causing your symptoms, or they have no tests to diagnose you, you are likely to be told that there is nothing actually wrong with you. The medical profession cannot easily admit to ignorance. In such situations, the only explanation that can be countenanced is that ‘you are making it up.’ Unexplained symptoms become ‘somatisation’. Side effects from drugs, such as statins, are due to ‘nocebo’ effects.

 

[JPV]

Most of them are nothing but drug pushers peddling dangerous and ineffective drugs for the pharmaceutical industry...

Drug Companies & Doctors: A Story of Corruption (The New York Review of Books)

Drugging America: The drug industry exposed (The Washington Times)

BTW, the Washington Times article has been scrubbed completely off their site. I had to link to a cached version.