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How Doctors Think

Summary

This book is about what goes on in a doctor’s mind as he or she treats a patient. Knowing this and what is the most effective language to use, patients can truly become a partner of their doctor, arriving at faster and more accurate diagnoses

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Key Takeaways
  1. William Osler is the father of patient centered medicine - being the first to understand and preach the importance of bedside manners
  2. How a doctor asks and responds to questions is key to making a patient feel safe and allowing them the space to open up and engage
  3. It is very important to keep a log of your mistakes and to revisit them often, keeping them top of mind and hopefully learning from that mistake so a similar one doesn’t happen again
  4. Heuristics are necessary but we must know which shortcuts we are using and how we are feeling so that we don’t develop blind spots or let our biases become too strong
  5. Most medical errors are not technical but errors in thinking, often stemming from a lack of awareness about how one feels
  6. Humans tend to overweight things which agree with and fulfill their current beliefs and desires
  7. The secret for caring for the patient is to care about the patient. This sounds silly and redundant but it is harder than it sounds because if you care too much it can impair your judgement but if you care too little you miss out on one of the most important aspects of being a healer
  8. If in a situation where you are very close to your doctor, worth saying how much you appreciate their level of care but also reassure hem that you want the honest truth and to do what’s best, even if it’s hard
  9. In an unusual situation, never accept “we see this sometimes.” Keep digging and asking questions
  10. Also ask, "What other body parts could be causing my symptoms?
  11. There will always be incomplete evidence but keep questioning doctors and their diagnoses, avoiding “diagnosis momentum” where things go unquestioned even if the situation is very unsure
  12. You need to know not only what people know but how they know it
  13. One size fits all scenarios rarely are the answer. Each person's body and context need to be adjusted to
  14. Make sure incentives are aligned. Prescription drugs, surgeries and other expensive therapies are often pushed on customers even when not needed or appropriate. Ask how time tested the procedure it is, how common it is, if it’s standard, etc.
  15. Doctors have to figure out the right path as best as possible and then find ways to get the patient to agree with that decision. You can not force or coerce patients to do something they’re uncomfortable with just because you think it’s the right way
  16. Often the doctor is more important than the hospital
  17. Is there anything that doesn’t fit?
  18. Is it possible I have more than one problem?
  19. Great doctors will think of lateral networks and non-medical reasons why treatments may be failing
  20. Today’s structure forces many doctors to try to get through as many patients as possible in a day but good thinking takes time. Find a doctor who will give you the time you need
  21. At the end of the day, medicine has to be a blend of science and soul
What I got out of it
  1. A good read into understanding a doctors world, their training, thought processes, common errors and how to best communicate in order to reach the best path to wellness

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