Learn from "How Doctors Think" by Dr. Groopman, MD
One of Dr Groopman's Key Findings in his book by this title is: To Reduce Mis-diagnosis: enhanced patient and doctor communications
Author: Dr. Groopman - He and his wife are medical doctors
- First hand knowledge both as doctor and "patient" as Groopman:
- Had medical condition difficult to diagnosis
- Multiple diagnosis over thee years by multiple, successive specialists [at least one he called the "best"] failed to find effective treatment
- Lived with chronic pain and ineffective use of right hand
- Preserved until found specialized able to diagnosis correctly medical condition and effectively treat it
Research Methodology: Survey physicians regarding: - Interfaces with their patients
- Information collection approaches
- Credibility afford previous medical tests and diagnoses by other doctors
- Response to symptoms not fitting particular diagnosis,
- Process followed, or Protocol, to arrive final diagnosis.
Groopman Findings: some of the reasons for faulty diagnosis are physician:
- Time constraints
- Production pressures based on "patients seen per day
- Over-Adherence to decision trees, or diagnosis protocols for undiagnosed medical conditions
- Most effect physician rely on "inner-direction" when protocols fail instead of telling patient return 6 months after trying nominal treatment and other approaches to avoid inability to know what's wrong with the patient
| Need for Paradigm Shift to The "Physician Innovator" by Richard Mayberry, Esquire
The Predicate for Increased, Accurate Diagnosis and thus more effective treatment are: - Increase time spent between doctor and patient
- Train doctors to facilitate two-way sharing of information between doctor and patient
- Train doctors to think "outside the box" on difficult diagnosis in older adults
- Reasonable compensation to physicians for time and skill that produce effect treatment for patient
- Patient, peer and community recognition for the "physician innovator"
- Remedial programs to remove physician bias towards older patients
Reasons For Missed Diagnosis: - Compensation not results based, but volume based
- Loss of dynamic, personal interest by doctors in individual patients
- Limitation by doctor of face-time with patience based on business model
- Bias against older adults who take more time for same compensations as younger adults
- Overly regulation of physicians preventing payment of fair market value for medical services
- Failure of medical profession to innovate in compensation plans so physicians are fairly rewarded who take more time, have effective two-way communications with patients, "think outside the box" when protocols fail, and preserve with patient until medical condition resolved
- Every disease subject different treatments [Groopman's view].
- Book dated, published 1997, and medical protocols have changed and presumptively improved
- Need for recent, comprehensive empirically sound study with peer view by national institution respected by both physicians and patient advocates
|
|