Patients and Doctors

I thought that Dr. Jerome Groopman's book was really relevant to some of the questions and topics that came up in last week's recitation regarding how doctors go through the process of evaluating their patients. One thing that Groopman seems to focus on is that regardless of how technically skilled or well certified a doctor may be, his or her approach towards evaluating you may miss certain possibilities. Groopman's examples include the young girl who saw multiple specialist doctors that misdiagnosed her celiac disease and doctors who utilize Bayesian analysis, a method of decision making based on algorithms and evidenced-based practice, which can fail in situations requiring novel or original analysis.

This book reminded me of the experience I went through when I broke one of my fingers my junior year of high school. I was taken to a local hand specialist, who recommended that I undergo surgery the very next day to realign the fractured bones. My father, who is also a physician, objected, and immediately took me to one of his colleagues who worked in a completely different city. There, the doctor, examined the X-rays of my finger and decided to simply put a type of soft-shelled cast on it. My finger ended up healing fine, and after some physical rehab it was back to full strength. Looking back, I think it's pretty crazy that I could have undergone surgery and elected not to, primarily because my father was there to give me guidance as well as take me to another doctor for a second opinion.

This book really made consider all of the different motivations that each player in this story had, for example, the hand specialist might have recommended surgery because he knew it was a far more expensive option than a simple plaster cast. Obviously, my dad didn't think such measures were appropriate, but was it based on his own medical knowledge or the relationship with me? I think the key thing to take away from this book is to remember that language and conversation are at the core of successful patient and doctor relationships.