Your Medical Mind: How to Decide What Is Right for You

  • Jerome Groopman & Pamela Hartzband
  • Penguin Press
  • 320 pp.
  • October 12, 2011

Two physicians parse the process of how patients and providers should work together in planning treatments.

Reviewed by Laura J. Larios

Your Medical Mind seeks to answer the million-dollar question: How do patients and providers arrive at the right medical decisions? Authors Groopman and Hartzband explore how, when decisions aren’t simply black or white, options can be evaluated and choices individualized to a person’s preferences. They discuss the biases of different personality types, and how people draw from past experience to make decisions in the present. Ultimately, understanding this combination is essential to both patient and practitioner when trying to make well informed decisions. The book also seeks to distinguish the role of patients and physicians in making choices, and it does so by including stories of real patients’ experiences, which makes for an easy read.

The authors start by sharing their own experiences as patients and what drove their medical preferences. They introduce the impact families have on shaping our attitudes as either optimists or pessimists — or, in their words, believers and doubters, maximalists and minimalists, naturalists and those with a technology orientation.

These are pretty self-explanatory. Believers are those that have faith in the system, doubters those who doubt and question the system. Maximalists believe in being proactive and trying everything necessary, while minimalists try to let the body heal itself and do little to intervene in the natural process. Naturalists relish allowing nature to do its thing, while those that are technologically driven put their faith in the latest and greatest.

By explaining these differences, it’s easier to see why there is so much variation between individuals and how they make medical decisions. This, combined with the experiences of those closest to them and the advice of trusted professionals, plays a role in final decisions. Each individual interprets risk, side effects, complications and outcomes differently, depending on his or her goals.

All these concepts are conveyed in a way that is easy to follow, providing just the right background information for both medical and nonmedical readers to understand.

In provider training, much emphasis is placed on learning the pathogenesis, symptomatology, diagnosis, treatment and prognosis of disease; the critical thinking needed to make the right decision for each individual patient is often underplayed. Many of the situations conveyed in this book are seen regularly in medical practice. Patients may receive similar diagnoses, but have different demands and goals. Spouting out a list of treatment algorithms won’t suffice; negotiating and collaborating is what that truly makes for good provider-patient relations.

There has definitely been a metamorphosis among patients, which this book highlights. Patients are no longer looking for someone else to make decisions for them, so the old paternalistic view of medicine is slowly fading away. Instead, many patients are highly educated, are experts on their condition in their own right, and are capable of making decisions that are good for them. The challenge for practitioners is to provide them with the tools necessary to make those decisions. Providers can qualify the wealth of data available to patients and provide good judgment based on clinical experience.

Rather than getting tangled in the conveyor belt of policy and standards of care, practitioners can be open to other treatment options, beyond what they’re used to. They can work to close the gap between patients and providers that often leads to misunderstandings and poor outcomes for patients.

Your Medical Mind is very successful at explaining both the complexity of medical decision-making and the differences between patients and how they process information about their diagnoses and treatments. The authors’ backgrounds as doctors add insight for those managing treatment, noting that there needs to be a heightened consciousness about one’s own biases. They provide helpful background information on the different personality types and make it easy for the reader to figure out where he or she fits.

I would recommend this book to both providers and patients; it does a good job of empowering patients to be their own advocates while being helpful as well for those in medical practice. The stories provide a personalized view of how final decisions were reached and are very good at explaining different medical conditions.

We are all patients at some point, and understanding our own complex thinking and motivations make this a good book for anyone to have. Although the authors don’t necessarily provide a global answer to the million-dollar question (not that one true answer exists), they do open up the conversation and bring to light many important factors that drive medical decision-making.

Laura J. Larios is a practicing physician assistant in northern Virginia. She works alongside a team doctor in a busy orthopaedic-surgery practice, assisting with clinical decision-making both intraoperatively and in an office setting.

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