Physician Innovator

 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
Issue Researched: why 15% +of medical diagnosis are wrong

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
Limitations to Groopman's study and findings:
  • 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