Thursday, February 14, 2008

Yeah, Yeah, Happy Valentine's Day

No riding today because I'm taking care of a sick child.

Without going into to many of the mundane details, I'll just preface this by saying I spend a good deal of my workday troubleshooting technical problems. I recently started reading How Doctors Think, by Jerome Groopman, M.D. because it sounded interesting and at the time I put a hold on the book I was spending quite a bit of time hanging out where doctors, um, think. It turns out that much of what is in this book can be applied to my job.

"Observers have noted that, on average, physicians interrupt patients within eighteen seconds of when they begin telling their story."

I think I have been guilty of that a few times in the past. You can make some quick assumptions about what the problem is and where you need to turn to get the answers. Still, it doesn't hurt to let people finish their story; they may ultimately get to a key fact that you might have missed.

Seemingly unusual or atypical presentations often get short shrift. "Common things are common" is another cliché that was drilled into me during my training. Another echoing maxim on rounds: "when you hear hoofbeats, think about horses, not zebras."

He goes on to say that you shouldn't forget, there are times that you'll find a zebra.

"Don't just do something, stand there," Dr. Linda Lewis, one of my mentors, once said when I was unsure of a diagnosis.

I love that quote. I see many cases were someone jumped the gun and did things that, ultimately, ruined my chances of figuring out what the initial problem was.

How Doctors Think is really more of a book for patients than for doctors. From the dust cover:

Groopman explores why doctors err and shows when and how then can -- with our help -- avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. ... How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track.

Yep, I am really enjoying this book and have no compunctions recommending it.

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Oh, and to the construction worker in the backhoe that I met yesterday: I tried to do as you suggested, but am unable to locate a phrenologist in my area. I appreciate your concern.

1 comment:

A Midnight Rider said...

My general practicioner gets paid by the minute when HMO is involved. We talk family, soccer, vacations, ten minutes or so later he asks "how ya doin".
Getting him to give up his six bucks for a referal is very difficult. Ergo his new car every year.

Did I say for get to put "ex" in front of general practioner above? My bad.