How Doctors Think
A physician discusses the thought patterns and actions that lead to misdiagnosis on the part of healthcare providers and suggests methods that patients can use to help doctors assess conditions more accurately.
Stats for nerds
6recommend
15mentions
8people
2009–2024years
60% recommend40% neutral
Mentions per year
What Hacker News says
- Acknowledging the risk of an echo chamber, maybe the ubiquity of these books means that they're tools of the trade. Knowing how to build a great software product/business is a useful skill set that these books teach well.
From there, the path to success comes from being well-rounded and exposed to new ideas/their accompanying opportunities. Read "The Power of Habit" because it's an incredible book, but then also read books specific to the domains to which you're applying those skills. Working for a healthcare company? Read "How Doctors Think". Jane Jacobs for urban planning, Foucalt for history...
It's wonderful that you (and likely half of the people on HN) have read many of these books, and I think having this list is useful for people outside the industry getting a mind for how tech thinks. At the same time, exploring the pantheon of great works in other fields is a virtue that, luckily is toted by many of the books mentioned above.
- Adding to this article (I'm not a medical professional and not giving advice), the same inferior medical outcomes are attributed to most, if not all forms of back surgery. Physical therapy outperforms most or all back surgery with much fewer side effects, etc. This is covered extensively in the book How Doctors Think (https://www.amazon.com/How-Doctors-Think-Jerome-Groopman/dp/...) as well as articles like this Ars Technica one: https://arstechnica.com/science/2017/02/doctors-lower-back-p.... You see the same with exercise outperforming anti-depressants in most cases, again with much fewer side effects. (For example: https://www.theatlantic.com/health/archive/2014/03/for-depre...)
The kicker is that doctors will often refuse these same treatments when offered, which is not a good reflection on their efficacy (again covered in How Doctors Think). This is not an indictment of modern medicine (which is often very effective on acute care), just a recognition of the limitations.
- If you find this article interesting you might consider the book "How Doctors Think". It's basically an entire book dedicated to the subject of misdiagnosis and how our modern medical system has some systematic flaws that contribute to it. If I think about just how often I'm incorrect in trying to diagnose an electronics or software problem, and how little time an average doctor spends on a problem, it's not surprising to me that anything that is remotely outside the norm could be easily misdiagnosed. For me the takeaway is to just accept that for common problems doctors can do a great job, but if you have a condition that is not making progress despite seeing a doctor be open to the fact their diagnosis could be incorrect. I had a minor problem with my ears a few months ago, went to a doctor, was given a diagnosis and treatment which temporarily improved the condition but did not seem to eliminate it. Went to another doctor a few weeks ago, given a different diagnosis and treatment. There you go.
- The Four Steps to the Epiphany - Steve Blank
Steve Jobs - Walter Isaacson
Artificial Life - Steven Levy
On Writing - Stephen King
Machine Learning for Hackers - Drew Conway and John Myles White
How Doctors Think - Jerome Goopman
Cholesterol Clarity: What The HDL Is Wrong With My Numbers? - Jimmy Moore & Eric C. Westman
Barbarians at the Gate: The Fall of RJR Nabisco - Bryan Burrough & John Helyar
- On the topic of "Doctor Fallibility" there's a really good book that I recommend to pretty much everybody: How Doctors Think by Jerome Groopman. There's a lot of info in there on how and why doctors make mistakes and, more to the point, information on how you - as a patient - can avoid being the victim of a mistake (more specifically, a mis-diagnosis) by your doctor.
The ideas in there wouldn't necessarily help with this X-ray scenario, but I think it's wildly useful information for anybody who ever sees a doctor.
- The book How Doctors Think makes that point very explicit and provides some useful tips for working with your doctor(s) to get the best treatment. I highly recommend it to anybody and everybody, FWIW.
Doctors are not infallible.
Case in point: After having a heart-attack, my GP and my cardiologist have both recommended I generally avoid taking Ibuprofen. Apparently it has some possible negative cardiac implications. OK, so a while back I was at the ER for some random pain, and the ER doctor said "take Ibuprofen". I told her that my GP and cardiologist both said not to, due to the cardiac risk and she goes "Oh, really? I didn't know anything about that. I'll have to go look that up. Thanks for the tip".
So yeah, even doctors don't always know everything. I mean, really, how could they? They're experts, sure, but their domain is too big, too vast, for any one to know all of it. It would be like expecting one of us to be an expert in all of C, C++, D, COBOL, Julia, R, Erlang, Forth, Haskell, Java, SQL, FORTRAN, Ada, Scala, and Clojure, AND know all about all of the latest libraries as they come out, AND know all about all of the newest emerging tools all the time. Nobody could possibly do that, and no one doctor can keep up with everything going on with medicine.
