Defines the nature and importance of clinical judgement. Although physicians make use of science, this book argues that medicine is not itself a science, but rather an interpretive practice that relies on clinical reasoning.
It also contends that there can be adverse side effects to assuming that medicine is strictly science. Author : Josh R. The development of this couple's relationship, with all of its problems, is reflected quite candidly in their experiences of living in an abusive relationship. This book speaks of the co-existence of a man and a woman who are trying to love each other and be committed for life but fail miserably.
The book is divided into sections, each recounting a different stage of their eleven-year relationship. Each section is followed by life lessons, so the reader can learn from what this couple experienced. Each lesson looks at the root cause of an issue. A few examples are: being victimized, broken trust, drug abuse, true friendship, etc.
These issues can exist in all intimate relationships today, so that all readers can benefit in learning from the relationship experiences. Author : Jerome E. Although learning disabilities are believed to affect a significant number of children, not all of those children receive an actual diagnosis. While school officials, teachers, and parents continue to improve education for these children, the general public still has misconceptions about learning disabilities and how to help those affected by them.
This detailed look at learning disabilities aims to educate readers through relatable text and engaging sidebars. Annotated quotes from experts, up-to-date statistics, and new technologies are explored, as well as the causes of and common misconceptions about life with dyslexia, dyscalculia, dyspraxia, and more.
In the last decade, interest has returned to the study of a cultural, rather than bureaucratic, model of the organization. Trice emeritus, Cornell U. School of Industrial and Labor Relations argues that essential to this study is recognition of occupations as potent subcultures, which adapt and interact within the context of the organization. C to return and answer some questions.
C said he thought the "leading diagnosis" was chondrocalcinosis , aka pseudogout. The resident had already informed Dr. Groopman that Dr. C's main way of handling bad hands was to fuse the bones, the same procedure he had had done to his back and which he was convinced had been a bad move on his part.
A year later, still suffering, Groopman consulted Dr. D, who did an exam and had x-rays done on both hands, stationary and flexed. There was a difference that led to the diagnosis that the ligament between the scaphoid and lunate was partially torn, which caused friction between the bones. This set off the inflammation.
Terry Light, agreed with Dr. Thinking back on his experience with the thinking of these doctors, Groopman comments: "A surgeon's brain is more important than his hands.
A was guilty of confirmation bias. B erred by stopping the search as soon as he found an explanation that made sense to him. He shut down his thinking and didn't explore further possibilities. He made a hasty conclusion.
So did Dr. C, although he wanted to do a favorite procedure of his, arthroscopy, to explore other possibilities. On the bright side, Dr. D explored the issue in an innovative and creative way that can't be taught. His method was a lot less invasive than what Dr. C proposed, although it is possible that Dr. C might have found what Dr. D did. Modern medicine may be evidence-based and a science, but doctoring is an art. The key to good doctoring is not only knowledge and experience, but good communication with the patient.
Too often, in doctoring and most other professions, good communication means the ability to get your point across clearly and effectively. You want to be understood and be able to persuade others to agree with you. This is not what Groopman is concerned with. He is concerned that a doctor communicate with a patient in the same way that a good defense lawyer hopes her client will communicate with her: disclose everything and let the professional determine its relevance and importance to the defense.
A good doctor communicates with the patient in such a way that the patient will reveal everything about her illness. Such communication requires trust. Confidentiality, not a topic covered by Groopman, is essential to gaining trust in both law and medicine. So is confidence in the professional, a topic Groopman returns to several times in his book.
Gaining confidence in a client or patient is difficult if either dislikes the other. You don't have to be pals with your doctor, but if you are turned off by his attitude, speech, or behavior, ten out of ten doctors should recommend that you change doctors. To doctors, Groopman advises something akin to what the ancient Greeks carved into their temples: know thyself.
Your negative emotions toward a patient or type of patient can block your ability to think critically about a patient's illness. Like the rest of us, doctors tend to like healthy people and, like many of us, are averse to the very ill.
If you've ever wondered why Bernie Siegal, Deepak Chopra, and other doctors quit practicing medicine and turned to giving talks and writing books about hope and other cheery things, it may be because they got sick of sick people.
Why has Andrew Weil , M. Maybe for the same reason. Maybe he doesn't like to be around sick people. Groopman cites favorably the work of Debra Roter and Judith Hall on communication between doctor and patient, especially in tough cases. Hall says that medical "competency is not separable from communication skills.
A patient must feel "free, if not eager, to speak and participate in a dialogue to get clues about the medical enigma before him. If the patient is inhibited, or cut off prematurely, or constrained into one path of discussion, then the doctor may not be told something vital. How many medical schools include a course in communicating with patients? How many of those courses focus on gaining the trust and confidence of the patient in order to encourage the patient to reveal as much information as possible about her condition?
How many doctors think this skill is essential to providing good medicine? Groopman does and I think most doctors who read his book will agree with him. Beside good listening skills, Groopman emphasizes the need for doctors to be good critical thinkers. One of the key skills of critical thinking is asking the right questions.
The most important questions to ask, he thinks, are: What might I be missing in this case? And what would be the worst thing that could be missed? These are questions asked by one of Groopman's models of good diagnostic thinking: Dr. Myron Falchuk. Another model of good thinking for Dr. Groopman is the cardiologist who told him that he keeps a log of all his mistakes. He revisits the log "when trying to figure out a particularly difficult case. You have to be able to critically evaluate them.
If you don't admit your mistakes, you'll never bother to figure out why you made them, what went wrong, and how to avoid the same kind of mistake in the future. But without good critical thinking skills, a log of one's errors won't do much good. Much of what Dr. Groopman advises doctors to do are the kinds of things students should be taught in an introductory critical thinking course. You need to know the pitfalls of thinking: understand the affective, perceptual, and cognitive biases and illusions that plague each of us.
Knowing these things is a necessary condition for critical thinking but it surely isn't sufficient. Delves into some insightful questions and ideas that should be viewed from all aspects of medicine whether giving or receiving of medical care Additionally, the book was well written and a quick read.
This book has affirmed many beliefs I have about my own profession. I found it refreshing to have some of the stories that are shared in theme by every physician be told in print.
Thanks for writing it. This is a must read for both patients and as physicians. Apple Books Preview. Publisher Description. Customer Reviews. Now, two days after Christmas , on a surprisingly mild morning, she was driving again into Boston to see yet another physician.
But her boyfriend had stubbornly insisted. Anne told herself the visit would mollify her boyfriend and she would be back home by midday. Anne is in her thirties, with sandy brown hair and soft blue eyes. She grew up in a small town in Massachusetts, one of four sisters.
No one had had an illness like hers. Around age twenty, she found that food did not agree with her. After a meal, she would feel as if a hand were gripping her stomach and twisting it. The nausea and pain were so intense that occasionally she vomited. Her family In a similar vein to Malcolm Gladwell's Blink , Groopman suggests that if doctors can become more aware of the thinking process that they go through to reach a diagnosis, and in particular to the role that their first impression plays in that process, they can become better diagnosticians.
He suggests that patients recognize that "misguided care results from a cascade of cognitive errors", and thus they can help the diagnostic process by presenting their symptoms in such a way that the correct diagnosis can be made Full Review words. This review is available to non-members for a limited time. For full access, become a member today. Reviewed by BookBrowse Review Team. Write your own review! Jerome Groopman, M.
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