ANS Review Groopman-HDT

The premise of How Doctors Think, by Jerome Groopman, is that most medical errors are cognitive rather than technical, and that with sufficient attention such cognitive errors can be, if not overcome, at least ameliorated. Groopman, a doctor and popular medical writer, did not set out to publish a systematic treatise on analytical mis-steps. Instead, the book is organized loosely by areas of medicine, and mistakes are illustrated in the context of vignettes from each field. The stories of medical misdiagnoses and successes alike make for a compelling read. Groopman writes in terms accessible to a lay audience, but also lays enough technical groundwork to enable further research by an interested reader.

As a scientist and an educator, I am aware that we are prone to many of the same cognitive errors as are medical doctors. In both roles, it is all too easy to cling to an initial ‘diagnosis’ of an experimental result, or even of a student. That said, this book is more of a surface, scattershot treatment of cognitive error than a systematic examination thereof. Moreover, Groopman seems overly and perhaps counter-productively critical of evidence-based medicine. Admittedly, ‘evidence-based’ movements (whether in medicine or education) have their own inherent biases, are often data-limited and thus narrowly focused on the areas for which data do exist, and otherwise miss key facets of the doctor-patient or student-educator relationship. However, Groopman may be throwing out the baby with the bathwater, since a systematic approach - with caveats - would likely act to eliminate bias rather than promote it.

Overall, How Doctors Think is an informative if incomplete, entertaining and vividly written book - in other words, the perfect read for an academic on vacation.