How Doctors Think

[Berkshire Road]

Has anyone else finished reading this? Would love to start a discussin re: the book and how it relates to us.

[ihurttoo]

I ordered my copy the other day, just waiting for it to come. Cant wait to read it! I know that Kara has read it or is currently reading it. It sounds like it is a great book! I take it that you liked it too?

[Kara29]

I wrote a post on this topic. Yes I did read the book. I have a LOT of thoughts on it and would be happy to talk about them. I've been thinking about a few things over and over again. Of course I know this is just one Doctor and his opinons. I wish more Doctors thought like Dr. Groopman. It would make our lives so much easier.

The following quotes were taken from the book "How Doctors Think" by Gerome Groopman, M.D. They are about what patients could ask thier doctors in order to reach some answers to what is happening.

Page 76

"What body parts are near where I am having my symptoms?"

"If the pain is new, on top of that long-standing problem, what body part might be causing the symptom." What we say to a physician, and how we say it, sculpts his thinking. That includes not only our answers, but our questions."

Also page 260

"Tell me the story again as is I've never heard it-what you felt, how it happened, when it happend. If he doesn't ask you to do this, then you can offer to retell your story. Telling the story afresh can help you recall a vital bit of information that you fogot. Telling the story again may help the physician register some clue that was, in fact, said the first time but was overlooked or thought unimportant. This will promot him to look in new directions for answers."

I was kind of hoping that this Doctor would have a summarized list of questions that we could ask our doctors. I read up until the very last sentance. I was going to compile a list of questions that we can ask our doctors after reading the whole thing, but these are the only quotes with questions that I came up with in the end.

Do you have any others? Maybe we can all come up with some things to take from this book to help us with our doctors.




Kara

[Berkshire Road]

Aw, go ahead Kara, you were the one who read it first! How about this: Who do you think needs to read this book more, doctors or patients? And why?

[ihurttoo]

I wrote a post on this topic. Yes I did read the book. I have a LOT of thoughts on it and would be happy to talk about them. I am scared to go first..........

Kara

Come on! Talk! I am dying to get my copy and am interested in what it says! I know others want to know too! Plus, what did you guys think about it?

[humpieumpumkin]

I would love to know what my doctors are thinking...I'm sure "she is a headcase" is one of those thoughts...

Erika

[Berkshire Road]

Yeah -- that's pretty much what the book says, actually.

[Trishann]

That would be great to know how to approach your doctor and ask the right questions? I am so lame at this thing. Please bring the ?, and make a list.

Sending hugs, Trishann

[jen74]

I read the book, and it is really good. It has a bunch of stories in it about how so many doctors have made careless mistakes when it comes to having good judgment when diagnosing an illness.
Also, I know that I was reading an article about how doctors perceive their paients as physcosomatic when they bring a list of questions with them to the the doctors appointment.
I think this is wrong on the doctors part, I think brining a list is a good thing so you remember everything you need to ask the doctor.
This book is a good read. It really describes how alot of doctors think and how they judge their patients.
Jen

[green_the_fish]

Also, I know that I was reading an article about how doctors perceive their paients as physcosomatic when they bring a list of questions with them to the the doctors appointment.

Oh, wow... I always heard you were supposed to go in there with a list, so you wouldn't forget anything! Does it say anything about why they always accuse us of having somatoform disorders? It is because saying "you are a hypochondriac; therapy is the cure" sounds better than "I'm sorry, I have no idea how to help you?" Do medical schools just train doctors to call people out as psychosomatic like that, if they have nothing that immediately appears to be wrong?

[Berkshire Road]

Um, basically, I think people come out of med school believing that they now know everything there is to know about the human body and what can go wrong with it. And of course, they don't, because not everything about the human body is even known at all yet! So, I think they do get frustrated and blame the patients when they can't find an answer. Not all doctors, certainly. But a lot of them.

I have three doctors among my siblings and siblings-in-law (three medical doctors, that is; everyone is a doctor of something in this family, LOL), and one of them is just such a stereotypical, "I know all things," kind of guy; he actually told me that no doctor would have accused me of being a drug addict unless there were substantial underlying reasons to believe that. I nearly throttled him... Fortunately, he is a radiologist and doesn't have all that much patient contact. The other two are family practice docs who work in the Indian Health Service is Taos, NM, and they take their patients very seriously and have a very holistic view of human health.

So, what I mean is there is no "one size fits all" description of how all doctors think, but Groopman's book does a good job describing a few different types of thinking that doctors use. Unfortunately, I think doctors need to read this book more than patients do; the doctors are the ones with the problem. But still, Greenie, I'd give it a go if I were you. Your library probably has it and it's a fairly quick read. You may not be able to change your doctor's approach, but you may at least get some insight into where he or she is coming from.

Any other opinions?

We ought to start a book-a-month club on here.

[Kara29]

I used this book today

When I went to my appointment today, I used a few of the suggestions Dr. G had with my Doctor and it was the most interesting visit I've had with a Doctor in many years. I think I had him scratching his head because he didn't see any of it coming.

I used this today: "Tell me the story again as is I've never heard it-what you felt, how it happened, when it happend. If he doesn't ask you to do this, then you can offer to retell your story. Telling the story afresh can help you recall a vital bit of information that you fogot. Telling the story again may help the physician register some clue that was, in fact, said the first time but was overlooked or thought unimportant. This will promot him to look in new directions for answers."

I told him my story over again even though I know he did not want to hear it but he heard something that I said today that changed the WHOLE Picture and saved me from a very serious operation. I also saved 6 months of waiting for a minor surgery.

I'd love to read more books about this and find more things to bring to my Doctors appointments.

I love your photos Carolyn. You have a BEAUTIFUL family!!

Kara

[Berkshire Road]

Oh -- why isn't there a blushing smilie? About those pictures -- thank you, Kara. Amy made me put them up... Jack and I feel profoundly fortunate to have our daughter (and our two rescued mutts, of course).

So, wow, you posted about the doctor's appt. but you didn't mention that you used Dr. Groopman's suggestions. That is so cool. I wish I had had the book eleven years ago when I started out on my journey to IC diagnosis. I bet you wish you'd had it back at the beginning, too. Maybe it would have saved us both some heartache.

Still, I really want to send copies of it out to our physician siblings. And I think it should be required reading for med students. I maintain that doctors need to read this more than patients do. But maybe patients can benefit not only in the way that you did, but in another way -- they can see that doctors are just people, fallible people, that they have a right to question. I see too many doctors and patients falling into this pattern of interaction, where the doctor doesn't explain himself and the patient feels stupid asking questions. Or the doctor makes assumptions, and the patient doesn't feel able to correct him.

I have really great, easy-going relationships with my two main doctors now, but it just took so long to find someone to take me seriously. And I think being female, and also having looked somewhat younger than I was for a long time, did not help my situation. Doctors talked down to me. They still do, when I have to see someone new. I feel like I always have to bring my husband or father with me, and I always have to inform the doctor that I am as well educated as he is and it's okay to use words with two or more syllables. And this is so wrong. It shouldn't matter if I'm married or not, educated or less so, everyone is entitled to be taken seriously and treated with respect, regarding our own health especially.

What do you guys think? Do we, as IC'ers, have a skewed view of the medical profession? Or is this really pretty pervasive? And what can be done about it?

So, what are we reading for May?

[Berkshire Road]

Kara -- I didn't come up with much of anything either. At least you were able to employ something from the book to some effect! I keep saying I think doctors need to read it more than patients, bc. I think that is the point he is making. It's his basic thesis, that some doctors don't listen well.

From the Introduction alone "...the sickest patients are the least liked by doctors, and very sick people sense this disaffection. ... Some doctors are averse to the very ill ... have deep feelings of failure when dealing with diseases that resist even the best therapy ... so they stop trying." (p.19). And, "...emotion can blur a doctor's ability to listen and think. Physicians who dislike their patients regularly cut them off...and fix on a convenient diagnosis and treatment. The doctor becomes increasingly convinced of the truth of his misjudgment... he becomes wedded to his distorted conclusion." (p.25)

So, what are we supposed to take away from that? Or do about it? Doctors tend to dislike patients who have complex problems, and then bc. they dislike us, they do a bad job treating us. I don't know about you, but I've certainly spent time in doctors' offices feeling completely powerless, knowing that the doctor was way off-base, but having no way to get him to change his thinking. And then if you try to go to a different doctor, hoping he'll have a different take, you get looked at with suspicion because you're "doctor shopping." So, I don't know, I really don't know. I guess maybe I see why things are the way they are, now, but I didn't take away much about how to deal with it.

I guess I sound a little sour. If anyone else has been reading this and can give us a more positive take on it, PLEASE chime in!

[ihurttoo]

I was just reading this thread, and all of your posts, thinking, "What incredibly smart women all of you are! It is no wonder that alot of Drs. are intimidated by patients like you all who are so intelligent, well-read, eloquent, and avid researchers!" I think it is b/c they know you guys know you are stuff and could call them out on things if they dont know what they are doing. I think alot of Drs. just want those meek and mild patients that think all Drs. know everything. When they come across a pt that knows her stuff, they just freak!

Remember back in high school, how there could be a smart girl who was also pretty, but nobody asked her out. Then, there'd be the dumb but pretty girl who was asked out all the time? Maybe it is sort of the same thing here. They dont want to be around someone that is smart, b/c then they may realize that they arent as smart as they thought they were, (and we know that anyone who spent all those years in school takes alot of pride in their intelligence! )

Not saying any of you guys should change! NO! NO! NO! You all are perfect just like you are, (and I am not just saying that b/c I am friends with all of you!) The only change to be made is to find different Drs. who arent intimidated by your brains.