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Oct 24, 2011floy rated this title 4.5 out of 5 stars
This book is important to all patients; it could make a real difference in your life. The author, a physician himself, critiques the way doctors often think. He estimates that 15% of diagnoses are wrong and that thinking more creatively, and one patient at a time, might help doctors diagnose better. He writes that doctors tend to disregard what conflicts with their diagnosis; they pay attention to what confirms their diagnosis, not what contradicts it. They feel a need to do something so they hurry a diagnosis. They rely on the judgement of other doctors instead of looking at the patient and the data independently. The author emphasizes the need for mutual respect between doctor & patient. If the doctor doesn't like you, your treatment may be affected. The vast majority of doctors, when surveyed, said they would instantly change doctors if they didn't like the doctor or felt the doctor didn't like them; that's how important compatability is. Also, medical school training overemphasizes using a matrix to determine diagnosis and that is not always the best way. Often doctors perpetuate whatever orthodoxy they were taught, even when there is evidence an alternative might be preferred. Radiologists disagree with each other's judgements 20-30% of the time. They disagree with themselves, when they look at an x-ray a second time, 5-10% of the time. Modern medical practice is increasing the pressure to see more & more patients, each one getting less & less attention. Obviously 2nd opinions are useful. In addition, patients & family can ask questions to assure better care. Ask the doctor: What's the worst thing that it could be? What organs are near the problem area? What else could be causing the problem? Is there any symptom or test result that doesn't fit with the diagnosis? Is it possible there could be multiple causes or problems? These questions will help the doctor think outside the box and hopefully provide better care. It's a good book that every patient and every doctor should read.