I have just finished reading the book "How Doctors Think" by Dr. Jerome Groopman (who also wrote "The Anatomy of Hope" which I think is a book listed on the OCF book list page). "How Doctors Think" is a book I'd recommend to everyone here who has to have an ongoing relaitonship with a doctor or doctors because of having had cancer (or even if you haven't, there's also a lot of good stuff in there about the errors primary care physicians can make as well).

I have to say I may be a bit biased in how fascinating I found it because it is really the cognitive psychology of medical diagnosis, reasoning and decision making and my Ph.D. is in cognitive psychology. Actually even my area of specialization was related in that I studied categorization--and of course that's exactly what medical diagnosis is. At the time I was in graduate school I did read a fair about about the psychology of medical diagnosis--but that was 15 years ago now so this was a welcome refresher. If I've just made that sound unappealing to anyone without my vocational interests, let me just say that Groopman is a great writer and illustrates all his points through really interesting examples (he also writes for the New Yorker magazine and you may have read some of his writing there).

I was just reading a discussion somewhere on these boards about how bad doctors can be sometimes about really spending the time that is needed on you--even when they are considered experts, etc. and that is one of his big points in the book is that the pressure on doctors to see a lot of patients leads to a bunch of cognitive errors.

I've seen some of these errors in my own treatment (though because of my training I actually didn't need to read the book to recognize what sort of error it was). For example, I was a victim of "satisficing" bigtime when the hospital here failed to see my esophageal stricture on the video of my first modified barium swallow test even though it was clearly visible and both a radiologist and a speech pathologist looked at it (I took a copy of the video to another hospital months later for a seocnd opinion and the speech pathologist saw it right away). But what happened was that during that test it was also clearly evident that radiation had worn away part of my epiglottis and that it was "stubby" as well as not moving entirely correctly. So they saw that first, decided that was why I was having problems swallowing and didn't even look down in the corner at what happened to liquid that made it down the esophagus.

Anyway, he has a list of good things patients can say to doctors to try to keep them from making these errors. (eg. for satisficing "if my symptoms aren't all caused by X, what else could be wrong?") Personally, I want to give this book to my ENT (who I think has a bit of the surgeon's overconfidence which also can lead to errors). IN fact, in the chapter on surgery the story he tells is his own and how he had to go to three nationally known hand surgeons before picking one (a fourth actually) to actually do the surgery. He was blown off in some ways by these doctors even though he was another nationally known doctor himself!

Anyway, I highly recommend this book. I am guessing it is one that many public libraries will have because of it's broad audience appeal and real usefulness.

Nelie