Justice for All through Health Courts

     

    

A Personal Book Review

  

      

     In his book How Doctors Think the author Jerome Groopman, MD presents an interesting perspective of human nature and clinical practice. He candidly discusses the causes of Medical Errors. In his own experience after much personal and professional reflection throughout his long career, he concludes that besides poor listening skills, detached clinical involvement, and lack of crystal-clear communication among patients and providers, “Diagnosis Momentum” is one of several derailers leading clinicians astray in their medical decision-making process.

 

        He also believed that many clinicians closed the diagnostic process loop prematurely. Thus, failing to begin a new diagnostic process on those patients with “difficult or elusive diagnoses”. This flawed approach or significant diagnostic short-sightedness is compounded because the clinician feels that all venues have been exhausted and there are no other differential diagnoses to consider given the fact that other providers sinched the most common presumptive dx, albeit wrongfully diagnostically speaking. Or our own clinical prejudices take us down the same path that others have ventured erroneously, therefore, failing to prove or uncover a disease state of the patient. 

        He also draws heavily from his colleagues & what he had learned from his colleagues (referrals) also seems to confirm his belief that whenever a misdiagnosis was involved in a negative outcome, it was always due to the rationalization that it was all due to psychosocial issues rather than organic issues. He also felt that many became less humane but more prone to stereotyping their patients.

        Dr. Groopman states clearly his thesis in the book introduction. Here he claims that a lack of inquisitiveness can increase clinical nearsightedness in any clinician.

 

        Fortunately, is not all doom and gloom, since medical error awareness has taken center stage in our industry. Systemic errors are increasingly recognized as many of the underlying factors contributing to medical misadventures.

 

         By understanding cognitively our shortcomings and negative attitudes, then we can begin improving healthcare delivery safety. But more so, by discarding those bad habits and incorporating our newly found knowledge and ethos can improve diagnostic reasoning.

 

So, yet another painful lesson can be learned from our practices. We need to maintain our patient advocacy call and vigilance up at all times and not let our professional guard down. We can no longer afford to be paternalistic nor disengaged or indifferent to the plight of our patients if we are to discard risky clinical outmoded practices. We can do better…we must do better. Without a doubt a great read for any clinician whether you're a novice or a seasoned veteran.