Given a BRCA1 mutation, should the patient go and have the operation to remove the breadth and ovaries. Paternalistic styles are out.
Physicians should lay down the choices clearly, and help the patients understand their own preferences in making a decision. Do not give false reassurances. Sep 21, Jonathan marked it as to-read Shelves: heard-on-mpr-npr. September 21, Whether making life-or-death decisions — or simply choosing a drug — we're flooded with information and conflicting advice. Doctors, the media, statistics, guidelines, family members and Internet strangers can all weigh in on the best medications to take or the most effective treatment options.
So how do you pick the best one? Sometimes they are believers in technology, sometimes they are believers in more natural remedies, but they believe," says Hartzband. Hartzband says that more than a third of all people do not currently fill their prescriptions or take their newly prescribed medications. Other patients fill the prescription and take the medication — but ask not to know about potential side effects.
This can also be dangerous, says Groopman. He explains that best practices, which have become more common in recent years, come from experts who designate a course of treatment for patients with certain conditions, based on evidence and scientific studies. For instance, many hospitals now instruct residents and attending physicians to give aspirin to people with chest pain and symptoms of a heart attack. But what's happened, we believe, is that many of these expert committees have overreached.
And they're trying to make [medicine] one size fits all and dictate that every diabetic is treated [the same] way or every woman with breast cancer should be treated [the same way]. March 14, 'How Doctors Think' "If you step back, you can have different groups of experts coming out with different best practices," he says. Within two years, a quarter of the best practices were contradicted, and by five years, almost half of the rules were overturned.
This is not to say that guidelines aren't useful, says Hartzband. She emphasizes that she and Groopman are not "anti-guidelines. She specializes in disorders of the thyroid and adrenal glands, and writes a bimonthly column with her husband, Groopman, for ACP Internist. Apr 26, Ann Heuer rated it liked it. I enjoyed learning how people might have a naturalistic or technology orientation, might be doubters or believers, minimalists or maximizers. The medical community has made excellent progress in treatment- it just sounds like healthcare providers need to have more training in HOW they deliver care and in illiciting thoughts from patients about how they want to be treated.
May 04, AleksandarOvnarski rated it really liked it. A useful primer on medical ethics, this little volume also contains discussion of different decision-making modalities that are helpful as case studies to augment large data in understanding how different individuals go about deciding what medical treatment to adhere to based not only on their doctor's recommendations, but also on their personal experiences, believes, financial situation and life expectations.
Palliative case is discussed and that might require a trigger warning for some; all di A useful primer on medical ethics, this little volume also contains discussion of different decision-making modalities that are helpful as case studies to augment large data in understanding how different individuals go about deciding what medical treatment to adhere to based not only on their doctor's recommendations, but also on their personal experiences, believes, financial situation and life expectations.
Palliative case is discussed and that might require a trigger warning for some; all discussions are strictly professional and the book is effective at conveying the diversity of people's decisionmaking processes. Depending on how much you enjoy this volume, it might pair well with the author's previous "How doctors think".
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Apr 28, Matt Young rated it really liked it. Quick read with some worthwhile points. One thing I want to remember from this book is the authors' discussion about the different mindsets of patients with regards to their medical decision-making.
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Minimalist vs maximalist, believer vs doubter, and naturalist vs technologist. Helping patients assign these labels to themselves might be useful in helping them decide what treatments are right for them. As for me, I am a minimalist, doubter, naturalist. We'll see if that changes at all over the cou Quick read with some worthwhile points. We'll see if that changes at all over the course of my life. Helpful and Informative A more wide ranging and quick to read book than I expected. Loved the premise that we ought to have health care that respects our individuality rather than completely out come based, system based, economic based, system based care.
Also glad it devoted time to routine choices, statins, BP management not only the dramatic cancer, end of life choices.
In 'Your Medical Mind,' Jerome Groopman and Pamela Hartzband Make It Personal
Will not hesitate to recommend. Dec 01, Devorah rated it really liked it. Groopman is a thoughtful, respectful, empowering doctor -- too much out of my real experience with the medical profession, unfortunately. This book gave practical credence to the pleas that patients should not only be engaged in their own care but should always hold the deciding "vote" on the best care choices. I wish there were a way to flag this kind of respectful care premise when reviewing health professionals in real life.
Oct 03, Jim Gleason rated it it was amazing Shelves: medical , self-help. Quick review: more anecdotal stories than I was expecting; felt at times the stories were repetitive; some good information. The only way to do this to become "health literary", so we could make best and hardest decisions to fit our personal need and preference among all available options, with less regret.
For cancer 1 the treatment lies in surgery, radiation or chemotherapy , watchful waiting palliative care 2 End of life issue: Health proxy surrogate ; advance care directive or living will ; intensive care treatment like v GRO Player GRO My summary: Everyone wants the longest life with highest quality. Being a doubter is uncomfortable, result in intense decisional conflict. Ethical principle of treatment: principle of autonomy: principle of beneficence: Often doctor's view of treatment best for patients may be against patients' will.
History: Family history, past medical history, social history. Naturalism bias: nature will take care of.
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- Your Medical Mind: How to Decide What is Right for You?
- Your Medical Mind - Jerome Groopman, Pamela Hartzband Interview - Auth?
- Your Medical Mind: How to Decide What Is Right For You!
Loss aversion: emphasize on loss, not pay attention to gain. Projection bias: p the physician's advice was framed to minimize the side effects of the treatment he's recommended and accentuate the side effects of other possible treatments. Focusing illusion: focus lives that would be negatively affected. Patients with "blank state" who has no preference of treatment is susceptible to the doctors' own preference for treatment.
Cohen Articles: 1. Feb 03, Nancy Kennedy rated it really liked it. This book addresses the issue of how we make decisions about our medical care. Most of the book is comprised of case studies, actual patients who had to make decisions like whether to take cholesterol-lowering drugs, have knee surgery or sign do-not-resuscitate orders.
Groopman and Hartzband let the patients talk at length. Their stories are not simple tales with black-and-white answers or outcomes. The patients dither, they procrastinate, they clam up when they should talk frankly, they cha This book addresses the issue of how we make decisions about our medical care. The patients dither, they procrastinate, they clam up when they should talk frankly, they change their minds, they reject medical advice.
Sometimes they do the right thing, sometimes they don't. I appreciated this ambiguity. We often read medical horror stories and think, "Well, I wouldn't have made a mess of it like they did. I would have done the right thing. Groopman and Hartzband do a fine job of identifying ways patients typically respond to medical advice, especially in the concluding chapter. You can skip right to that one, if you want: some people are believers, some doubters, some trust in natural therapies, some in technology, some people are minimalists, others maximalists.
Most of us harbor some mix of these tendencies that guides our medical decision making.
our Medical Mind: How to Decide What Is Right for You | Book Catcher
I'm not sure the book addresses "how to decide what is right for you" as the subtitle suggests. I found the book to be more descriptive than prescriptive. And, I suspect that when most of us become patients we won't have the same luxury to weigh options and come to reasoned conclusions as the people in this book did. After a while, I just wanted to shout at some of these folks, "Take the pill!
Have the surgery! I think we tend to believe that if we just sign advance directives and health care proxies, we're covered. But the case study here shows that little by little, small step by small step, a family can be drawn into procedures and treatments they were certain they didn't want. If these case studies simply get people talking more honestly and openly to their doctors and their families, these authors will have done a great service with this book.
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Oct 09, Emily rated it really liked it Shelves: non-fiction. In Your Medical Mind , Drs.
Groopman and Hartzband have created something of a sequel to Dr. Groopman's earlier How Doctors Think. This book, however, focuses on the patient's part in the medical decision-making process. The authors provide some very practical suggestions for patients which at some point will include just about everyone in dealing with the sometimes overwhelming volume of information presented regarding diagnoses and various treatments, and what to do when the experts don't agr In Your Medical Mind , Drs. The authors provide some very practical suggestions for patients which at some point will include just about everyone in dealing with the sometimes overwhelming volume of information presented regarding diagnoses and various treatments, and what to do when the experts don't agree.
They also present a way to identify what type of medical decision-maker you are. Generally, everyone falls somewhere between a naturalist bias and a bias toward technology, between being a maximalist and being a minimalist, and between being a believe and a skeptic or doubter. Knowing your individual tendencies, it's easier to be aware of any pitfalls of those frames of mind and to, therefore, make better decisions.
They point out frequently that even experts often disagree on the "best practice" and which treatment they recommend.