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

by Jerome Groopman

Making the right medical choices is harder than ever. Whether we’re deciding to take a cholesterol drug or choosing a cancer treatment, we are overwhelmed by information from all sides: our doctors' recommendations, dissenting expert opinions, confusing statistics, conflicting media reports, the advice of friends, claims on the Internet, and a never-ending stream of drug company ads. Your Medical Mind shows us how to chart a clear path through this sea of confusion.

Drs. Groopman and Hartzband reveal that each of us has a set of deeply rooted beliefs whose profound influence we may not realize when we make medical decisions. How much trust we place in authority figures, in statistics or in other patients' stories, in technology or in natural healing, and whether we seek the most or the least treatment--all are key factors that shape our choices. Recognizing our preferences and the external factors that might lead our thinking astray can make a dramatic, even lifesaving, difference in our medical decision making. When conflicting information pulls us back and forth between options, when we feel pressured by doctors or loved ones to make a particular choice, or when we have no previous experience to guide us through a crisis, Your Medical Mind will prove to be an essential companion.

The authors interviewed scores of patients and draw on research and insights from doctors, psychologists, economists, and other experts to help explain the array of forces that can aid or impede our thinking. They show us the subtle strategies drug advertisers use to influence our choices. They unveil the extreme--sometimes dangerously misleading--power of both narratives and statistics. And they help us understand how to improve upon a universal human shortcoming--assessing the future impact of the decisions we make now.

Genres: Nonfiction, Medicine, Health, Medical, Science, Self Help, Psychology

322 pages, Kindle Edition

First published September 20, 2011

About the author

When Dr. Groopman is not in his laboratory at Boston’s Beth Israel Deaconess Medical Center, where he is chief of experimental medicine, he focuses his expertise as a hematologist and oncologist as well as his compassion on the inner workings of his patients. It is this unusual nexus of medicine, healing and faith in the preciousness of life that characterizes Dr. Groopman’s career and core being. At age 44, Dr. Groopman turned his gentle yet meticulous lens to writing about his patients’ courage, endurance and resilience.

Though he considers himself a scientist and physician first, his eloquent pen captures the pace and pathos of medical mysteries and human dramas. The Measure of Our Days (Penguin) was published to critical acclaim and inspired the ABC television drama Gideon’s Crossing. In 1998, The New Yorker asked Dr. Groopman to become a staff writer in medicine and biology.

Reviews

[Barbara (The Bibliophage) · Rating 4 out of 5]

I found Jerome Groopman’s book How Doctors Think helpful and enlightening. So when I happened across Your Medical Mind: How to Decide What is Right for You, written by Groopman and his wife Pamela Hartzband (both are MDs) I grabbed it right up. In truth, I also chose it because I have an important medical decision to make regarding surgery. I was hoping Groopman and Hartzband would again enlighten me.

The structure of the book follows from the least of the difficult medical decisions we may need to make to the most difficult. It acknowledges that choosing whether or not to take a medicine is considerably different than discussing what “no heroic efforts” means to a dying patient. This structure helps give context to the complex ideas Groopman and Hartzband put forth. Detailed patient stories are used throughout to illustrate the concepts as well, and this makes the book more readable and heartfelt.

Full review at TheBibliophage.com.

[India M. Clamp · Rating 4 out of 5]

Do you have family member in the hospital? Perhaps you have a loved one with a “Do Not Resuscitate” order? Are you afraid to pull the plug on Mom or Dad? If yes, then you need to buy this book!

Divine read! Dr. Jerome Groopman's and Pamela Hartzband's "Your Medical Mind: How to Decide What is Right for You" takes you on a dangerous tour with life experiences and stories of difficult medical decisions. Groopman and Hartzband took me down a treacherous flowing river armed with a boatload of knowledge to the patients’ hospital deathbed.

Your Medical Mind illuminates in simple terms past bias of Patients and their Families and how it can adversely engender an anxiety pregnant or even terminal medical decision on the part of the family. This book offers a surreptitious view into some of the most arduous decisions facing the medical community, patient and family.

Essential book for Physicians as well and offers lifesaving advise to the commonly forgotten Physician with “When taking care of me, take care of you to make sure you don’t burn out by the only time your optimism is needed most” (116, Groopman & Hartzband). Crucial must-read for Medical Students, Physicians and Families, this one is being added to my Queen Bee list for the golden poetic wisdom found within.

[Susan Daly · Rating 5 out of 5]

Dear Readers,

I really liked this book because it explained to me, in a way I didn't know, but thought I did, exactly how a person's living will works out in the end.

It also explained a ton of things to me about how my personal opinions about my own medical treatment have been formed all through my life, and, unbeknownst to me, through the way my own Mother, Grandparents, and even Great-Grandparents felt, and/or thought about doctors, medicines, well, everything to do with how I would end up choosing how to decide what to do in my very own medical emergencies. I have had six near death situations with my own life already, yet I really had absolutely no idea how or why I choose the physicians I chose, nor why I did or did not accept certain medical treatments.

This book goes into many patient's (no names of course) histories and why they chose what, when, and how to take care of their own personal medical problems.

To me it is a fascinating book because I do have very many various medical problems. I had always thought I knew exactly why I opted for this treatment, or that treatment; that is of course, the few times I had a choice at all.

I'm not positive, but I do believe that this book will really resonate with people who are living with serious diseases, as I am, and/or have taken care of loved ones who have had serious diseases, which I have done also. But, that is of course simply my own opinion, I could be totally incorrect about my belief!

Great reading to all, and to all a Ta Ta!!

Susan a.k.a. Suky/Suda

[Najwa · Rating 5 out of 5]

One of the best books I have ever read so far. As great as " How Doctors Think ". Groopman's writings have always amazed me in many ways. I liked how this book navigates through the mind-set of patients analyzing the decision process and how preferences have a major influence on the way decisions are made. I honestly feel changed after reading this book. It opened my eyes to a whole new way of thinking that I believe it will help me as a " doctor " & as a " patient " to better formulate my judgments.

[Sandeep Reddy · Rating 3 out of 5]

3.5 stars

I lost two major battles against death in the last couple of years. Once when I fought along my father and once along with my father in law. When I saw this book and it’s reviews, I thought it would show me what mistakes I made in those battles and how can I fight better by showing me some decision frameworks and numerical techniques. But the book is full of stories of individual patients and their stories which I think is the first lesson for me- Medicine is such an uncertain science that almost every decision is personalised.

The other major takeaway for me is that the examples somehow crystallised the fact that “it’s just a matter of when and not a matter of if”. Having never been hospitalised, that takes some effort to wrap my head around but it’s a start. And I am much more sure now of getting an annual full body check up done without fail.

Wanted a light read after some dense reads and this was definitely light but had some shadows lurking for me. Good read overall. Was not a very “useful” book but definitely not disappointed at all to have picked it up.

PS- one specific thing that I learnt from the book that I could have done in my battles is- to have “the conversation”. I never did that and next time I probably will.

[Lisa · Rating 3 out of 5]

Although I really liked Groopman's How Doctors Think, I liked this book less well. While no book could really tell you how to make medical decisions, this reminded me of the information you get when trying to make financial decisions--consider your acceptable level of risk, etc. Groopman goes further to give a few continuums (continua?) along which you may fall in considering a medical decision: Are you a doubter or a believer in the power of medicine and in your doctor's advice? Are you comfortable with technology or do you prefer a natural approach? Are you a minimalist (do as little as possible and let your body work on the problem) or a maximalist (throw everything available at the problem)? Are you a person who wants a lot of autonomy or do you want to have your doctor tell you what to do? He presents these possibilities in the context of decision-making by patients who are faced with prostate cancer, breast cancer, perhaps optional surgery, and end-of-life care, as well as people who are the surrogate decision makers for the patient (i.e., durable power-of-attorney designee for a terminally ill or unconscious person). Of course, some chose well and some had regrets or were disappointed. (Regret involves an element of self-blame that disappointment doesn't.) He also gives some good questions to ask: not just how many people benefit or suffer side effects from a treatment or medication (after all, "the majority" could be 51% or 99%), but how many people do you have to treat or medicate (and at what dose?) before someone receives a benefit, or how many people do you have to treat or medicate before someone suffers a particular side effect? The main thing I take away from the book is that I don't want to be in a position to make these difficult decisions, but when I am, I hope I can remember Groopman's advice (or remember to read this review). The author also presents some interesting results on how people with advance directives tend to change their minds about receiving care or not when they get in that situation. (Another continuum--patient's expressed wishes or doctor's assessment of patient's best interests?) And that people are not good at judging how well they will be able to tolerate a particular side effect or condition--we are more adaptable than we think we will be. And that decisions made in a hurry under pressure differ than those made with cool deliberation, although we knew that and can't always control it. So don't get sick or injured. And good luck with that.

[Ann G. Daniels · Rating 5 out of 5]

Jerome Groopman, medical writer par excellence, has written another fascinating book, this time with his wife, also a doctor. This book is a must-read, since it's about something we all face: how do we think about medical decisions? Do we favor aggressive treatment or do we prefer to do as little as possible? Do we put our faith in what our doctors say, or are we skeptics? Do we love medicine and technology, or do we prefer natural remedies and letting the body heal itself? Even more importantly, it's about how understanding how we view these issues can help us make medical decisions that are better informed and that will make us happier, even if the outcome is not great.

As with Groopman's other books, the stories of many patients are woven throughout, including those of the authors. These stories illustrate the various lessons of the book and, as the authors intend, lead the reader to consider how our own backgrounds, family and medical histories, upbringings, and temperaments incline us to be more or less comfortable with different approaches to medical treatment. In addition, they add almost a voyeuristic thrill as we see intimate details of strangers' lives and are asked to contemplate how we may be similar to or different from the people whose worlds we are peeking into.

[Andy · Rating 5 out of 5]

Fascinating and very thought provoking.

As a retired physician (oncologist) , who is now on the receiving end of medical care, I found this book to be very thought provoking and valuable. Being on the physician side of making decisions is very different from now being on the patient's side of the struggle. There really are many times no easy or certain answers. Drs and patients must recognize and understand the "uncertainties" that are ever present in modern medicine.

[Linda Vituma · Rating 4 out of 5]

Palīdzoša grāmata - domas skaidrībai un spējai jēdzīgi orientēties realitātē medicīniskās aprūpes jomā (gan kā aprūpes sniedzējai, gan saņēmējai).

It kā šķiet tik vienkārši - mācīties faktus un prasmes un attīstīt domāšanu un izpratni. Tomēr dzīvē nemaz tik bieži nenākas piedzīvot harmonizētu, visaptverošu aprūpi. Tik bieži ir iespēja piedzīvot manipulāciju veiklību bez dvēseles vai holistiskus izteikumus bez piesaistes realitatei. Bet gribas abus. Gan sniegt, gan piedzīvot.

[Amber Donovan · Rating 5 out of 5]

Highly recommend this book to people aspiring to be doctors but even patients can benefit as well from this book!

[Tom · Rating 3 out of 5]

This book is important. Not especially exciting, but definitely important. At some point in our lives we will all get sick or hurt and eventually we will all die. It is very likely that when those things occur, we will receive treatment from the medical community. And we or our loved ones will have to make difficult yet crucial decisions about that treatment.

Through a series of case studies, Your Medical Mind examines how real patients receiving medical care made decisions about whether to get treatment, what kind of treatment to get, which doctors to trust, and how far they wanted those treatments to go in life-threatening situations. It starts with the relatively straightforward question of whether or not to take medication for high blood pressure and proceeds to more life-threatening scenarios.

Most people don't plan for the complicated decisions they may be called on to make while sick or dying because they can't imagine being in those scenarios until they get there. So reading about people who have been in such situations is illuminating.

Perhaps the biggest message that the authors of the book have is that decisions about treatment are ultimately always in the patient's hands, no matter how authoritative the doctor may sound. So for the patient, knowing what they want is important.

Patients tend to fall in a spectrum in terms of how they make medical decisions. The authors identify an axis of natural healing vs technology, another one of minimal treatment versus aggressive prevention, and still another of skeptic versus believer. So for example, a patient who is very skeptical and a minimalist will want to weigh all treatment options for themselves, regardless of what medical experts tell them, and will probably take the least treatment possible. A patient who is a believer and a 'maximalist' will do everything the doctor recommends and then some, in hopes of preventing future problems.

Critically, neither approach is right or wrong; the patient needs to decide what is right for them.

Medicine is not an exact science. Specialists often disagree about the best course of treatment. Even when medical opinion is fairly united, not everything is right for everybody. The authors recommend patients ask about 'number needed to treat' and 'number needed to harm' when weighing the potential benefits of a treatment against its costs.

One interesting thing the book talks about is the idea of 'living wills'. Studies have found that living wills are often not that effective, because healthy people can often not predict their own wishes when they are very ill and in need of dramatic medical intervention. Simply put, people change their minds. People are also surprisingly capable of adapting to limitations, often much more so than they predict they will be. So a healthy person may think, for instance, "I wouldn't want to live if I had to be hooked up to a machine," and then find that when that time comes they feel quite differently.

At any rate, a lot of food for thought here even if the book isn't completely riveting and the tone is rather clinical.

[Yaaresse · Rating 3 out of 5]

I feel like I'm asking this question a lot lately, but who comes up with book titles these days, and is it a requirement that said person read the book first? Based on the disconnect between titles and materials, I'm inclined to think the answer to the second part is a firm "no."

There is some good information in this book, but the title implies it might offer some specific suggestions for things to think about when deciding on medical treatment. It really doesn't What it offer are a lot of case studies, some theories on how patients approach information or treatment options, and some vague back and forth about quality of life versus longevity and how patients find it hard imagine themselves in a dire health crisis beforehand. Not useless, but really that helpful. It seems to be more a book aimed at explaining patient decision-making strategies to doctors than one on explaining to the patient and proxy how to navigate or negotiate with the medical industry. While the concept of patient "types (that patients are either minimalists or maxilmalists, doubters or believers, and naturalists or technophiles) is interesting, it seems like something most people already know about themselves and fairly common sense. That people will often change their minds when presented with new information or when neck-deep in a new-to-them situation also seems pretty common sense.

While the doctors touched on the effects of advertising of medications to end user, shortcomings of quantifying every aspect of medical care, restrictions on patients and doctors by the insurance industry, and limitations of living wills, they didn't offer any answers for how to better navigate or negotiate these things. "This is what other people did in very specific situations" and "it's hard to know what to do" aren't really much help when I sit down to update my DNR or Living Will.

[Gary Meade · Rating 4 out of 5]

A riveting read of case studies on how different people choose treatments. Especially relevant when you have a health condition (or conditions) and feel unsure as to the right way to go.

[Jill · Rating 4 out of 5]

Your Medical Mind isn't the kind of book I would have picked up 4 to 5 years ago, and most definitely not when it was first published 8 years ago in 2011. But having entered that season of life when one becomes acutely aware of one's mortality and that the days of one's peak physical condition are long past, this is an important read. If you're not medically trained and should you fall sick, how might you decide what treatment option is the best for you? How to navigate the masses of (often conflicting) information from various sources - from doctors (first, second, third opinions), friends and family and, of course, the Internet? How to make important decisions that could literally mean life or death when your physical and mental state is hardly conducive to considered thought?

In most cases, there is no definitive answer on when to treat or how to treat. It is not evident what the best option for an individual might be. In their book, Jerome Groopman and his wife, Pamela Hartzband, argue that the best decision for an individual is one that they must feel at peace with, that it is one that is consistent with their values and priorities. Values and priorities are highly subjective. Yet, in medical decision-making, the focus is often on quantitative data - probabilities and estimates, frequencies and proportions. Groopman and Hartzband argue that we must first understand what our decision-making preferences and orientation is - are we maximalists (desiring everything possible to be done) or minimalists (wary of over treatment and will refuse intervention unless absolutely necessary); believers (who operate on the premise that there is a successful solution for their problem somewhere and they just have to look hard to find it) or doubters (who are deeply risk averse and are wary of the potential side effects of any treatment option); having a naturalism orientation or a technology orientation? These preferences are the product of our upbringing (what did our parents bring us up to believe? that we should do exactly as what the latest research advises? or that "doctors don't know everything?) and of our personal experiences. And it is only when we are aware of our preferences and orientation that we can unpack the hidden influences that can sway our thinking and distort our judgement.

This might understanding might lead one to look for a doctor who shares the same orientation - a maximalist doctor for a maximalist patient and a minimalist doctor for a patient who prefers fewer and less aggressive interventions. But perhaps it is more important to look for a doctor who may not share your preferences but understands and respects them, who will facilitate your decision-making process but is prepared to challenge it if necessary. By sharing the medical decision making with a doctor who understands your preferences, you share "the burden of choice, so you lessen your risk for regret".

The focus of Your Medical Mind is very much on the individual and how we can help people make medical decisions they can be at peace with. But it sparks reflection on what this might mean for how most healthcare systems are set up today, which aim to "standardise treatments rather than customise them to the individual" and "reduce the experience of illness to numbers". In our quest for resource efficiency, we may try to roll out standard protocols and regimens but is this truly in the patient's best interests? Patients care not only about treatment outcomes and waiting times (although these are up there in terms of priority), but they also want to feel respected, reassured and comforted. The anecdotes in Your Medical Mind remind us that medicine is not only a scientific endeavour, but is ultimately a very human one.

[Lone Wong · Rating 4 out of 5]

Reading this book makes me realized we really need to take care of our health since young. There are a lot of cases about cancer treatment and medicine topics arise on the internet for many years. People and experts have been debating the pro and the cons of health supplement and medicine consumption for people. And there are many controversial topics about the health care industry manufacturer's products whether or not, are they genuinely been contributing for the benefit of the people's health or making money from the people.

Advertisement for drugs may include statistics, but fundamentally these are the ads that designed to tell a compelling tale to the people who consume the media. Very often in medicine, there is more than one way to address a problem. As we all know, much of medicine is still an uncertain science, existing in a gray zone, not clearly black or white. It might confuse people and paralyzed our decision making when coming to the crucial moment in our life. Illness.

In this book, the author describes that the overloaded information on the internet and also by the relatives of our family are often paralyzed our decision making. How do we know what is actually right for us? The answer often lies within us, not the experts. Because ultimately, it the patient who benefit from the treatment or suffers the consequences of its side effects, so ultimately it is the patient who should decide.

Before we go for a treatment, we should always do the research and ask ourselves, "What do we read about the treatment? What did the doctors tell us the side effects? What are we willing to live with? What does it take to deal with the particular conditions?"

The author describes there are few types of people when comes to decision making for the treatment. Believers and doubters; maximalists and minimalists; naturalism orientation or a technology orientation. As we grow up, we broaden our exposure to the experiences of colleagues, friends, and acquaintances. We hear the tales, try to locate ourselves in them. We imagine how we would make the decision when coming to the situation in life. Cognitive psychologists call it "Availability Biases", and it is often that the circumstances of our life that influenced our mindset to decision making.

It is a very useful and practical book for people to read and ponder about decision making, not only in medical treatment but also in every aspect.

[Morven · Rating 5 out of 5]

If you're facing a large medical decision, considering changing doctors, or involved in end-of-life decisions for relatives or friends, this book provides invaluable information. It helps you decide what your (or your beloved one's) preferences are and how that affects your relationship with your doctor. ("Are you a minimalist or a maximalist, a believer or a doubter, do you look for natural healing or the latest technology?") Even if you think you know (I thought I did), your attitudes may have changed over time, and this book helps you understand that.

It helps you understand statistics as they apply to medications and treatments. I had never heard of "the number to treat," but apparently asking this question about prescriptions is important. For example, your doctor wants you to take a statin. Of course, you consider side effects, warnings, and so on, but you need to know this number. (For example, for every 300 people taking a statin, only one heart attack is prevented.)

The book talks about living wills, what they do and don't cover, and how nearly impossible it is to really understand what you would or wouldn't accept because you've never experienced it before. Case studies illustrate decisions about being put on a ventilator and the common misconception that it's permanent and you'll be a "vegetable" if you agree to one.

Definitely recommended reading.

[Jonathan]

http://www.npr.org/2011/09/21/1404389...

September 21, 2011
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?

"There is no one right answer for everyone," says Harvard Medical School oncologist Jerome Groopman. "But it's very important for people to understand how the information applies to them as individuals and then to understand ... their own personal approach to making choices ... so that they're confident that what they chose is right for them."

Groopman and Pamela Hartzband, an endocrinologist at Harvard Medical School, have teamed up to write Your Medical Mind, a guidebook for patients trying to sift through medical choices and make the best decisions for themselves and their family members.


Your Medical Mind
How to Decide What Is Right for You
by Jerome Groopman and Pamela Hartzband
Hardcover, 308 pages | purchase
nonfiction
science & health
MORE ON THIS BOOK:
NPR reviews, interviews and more
Read an excerpt
Believers and Doubters

Groopman and Hartzband say most patients generally fall into two categories: believers and doubters.

"The believers are convinced that there's a good solution to their problem and they just want to go for it. Sometimes they are believers in technology, sometimes they are believers in more natural remedies, but they believe," says Hartzband. "And the doubters are people who are always skeptical, worrying about side effects, worried about risks and that maybe the treatment will be worse than the disease."

Recognizing where someone lies on that spectrum is helpful for both patients and their physicians, says Hartzband.

"Understanding why a patient wants something or doesn't want something really helps you lead them to the best possible choice," she says. "It helps patients understand where you [as the physician] are coming from and vice versa."

Patients who fall into the doubter category may worry about whether prescribed medications are necessary, which could lead to noncompliance with a doctor's orders. 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.

"I want to make sure if the patient's feeling something, he or she is alert to it so that I can intervene as early as possible to prevent it from spiraling out of control," he says. "If a patient says, 'I want to take the drugs but I don't want to know about any side effects,' I say, 'Let's backtrack a little and see what's important for you to know, because I want to make sure you're getting the best and safest care.' "

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The Limits Of Best Practices

Sometimes getting the best and safest care also means realizing that guidelines or "best practices" aren't engraved in stone, 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.

"That kind of [emergency] medicine is amenable to standardization and best practices because it really doesn't involve patient choice," says Groopman. " ... 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]."

Treating the patient as an individual — and not as a statistic or algorithm to be solved — is vitally important, says Groopman, because the best and safest care might not always be standardized.

Dr. Groopman on NPR
March 16, 2007
Groopman: The Doctor's In, But Is He Listening?

March 14, 2007
'How Doctors Think'

"If you step back, you can have different groups of experts coming out with different best practices," he says. "And what that tells you is that there is no right answer when you move into this gray zone of medicine."

From an analysis of 100 best practices put together by committees in internal medicine, Groopman and Hartzband discovered that 14 percent were contradicted within a year. 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."

"Guidelines have an enormous amount of very useful information, and I think they can be extremely helpful," she says. "But they shouldn't be applied in a blanket way without thinking about the individual patient."

Dr. Jerome Groopman is the Dina and Raphael Recanati Chair of Medicine at Harvard Medical School. He is also a staff writer for The New Yorker in medicine and biology and the author of several books, including The Anatomy of Hope and How Doctors Think. Dr. Pamela Hartzband is a faculty member at Beth Israel Deaconess Medical Center, Division of Endocrinology, and Harvard Medical School. She specializes in disorders of the thyroid and adrenal glands, and writes a bimonthly column with her husband, Groopman, for ACP Internist.

[Daniel · Rating 5 out of 5]

Wow. This well written book introduced the various medical decision making faces by patients every day. There is:

1. Whether to take a statin, or a blood thinner, with potential benefits and side effects.
2: What treatment to choose for prostate cancer: traditional surgery, robotic surgery, radiotherapy or nothing. Given a BRCA1 mutation, should the patient go and have the operation to remove the breadth and ovaries.
3. End of life problems: how to decide whether ‘heroic measures’ should be undertaken.
4. Medical proxy: the difficulty and stress the surrogate feels trying to beat guess the patient’s wish.

From the doctors’ point of view, it is also informative. 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. The ‘best’ doctor may not be the most suitable for everyone.

[Eric Satlow · Rating 4 out of 5]

I think that the subtitle, "How to decide what is right for you," is somewhat misleading. It gives the sense that there might be very specific advice about decision-making in difficult medical situations. However, what is clear is that not only are medical situations fraught with uncertainty - diagnosis, treatment, and outcomes - each with its own complex set of interacting variables, decisions along the way are similarly complex and uncertain. As a result, Groopman and Hartzband can identify broad issues for consideration but there really is no roadmap. Welcome to life! Before facing life-altering illness, learn what's important to you about medical care and treatment; recognize that decision-making is subject to cognitive biases, presentation of medical data, and your own changing feelings and well-being. The real-world stories the authors employ are compelling, particularly those regarding end of life; and bring the world of patients, doctors, and decisions to life.

[Ann Parker · Rating 3 out of 5]

I agree with other reviews of this book- content is good but doesn’t exactly match the title. The title should be “The Medical Mind: How Patients Make Medical Decisions and How Doctors Can Respond”. I enjoyed learning how people might have a naturalistic or technology orientation, might be doubters or believers, minimalists or maximizers. However, I do think the book paints a poor picture of medical research- “the numbers”- and professional guidelines that are enforced by the government. 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.

[Aleksandar · Rating 4 out of 5]

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".

[Jessica Williams · Rating 3 out of 5]

I got this recommendation from my grandpa, so I had some high hopes going into reading this book. I was intrigued by the idea of it and the call for doctors to use a more person-centered approach rather than standard similar care for all. However, I was equally confused because some parts gave a very “anti-Westernized medicine” feel but the authors are doctors??? I would’ve also liked to see more recommendations moving forward of how we can transform the healthcare field - there wasn’t really much direction and ideas, but simply a statement of many problems. It was sort of just a call for patients to question their level of care and healthcare in general, which I understood to some degree.

[Matt · Rating 4 out of 5]

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. 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 course of my life.

[Devorah · Rating 4 out of 5]

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.

[Kitty Davis · Rating 4 out of 5]

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. Will not hesitate to recommend.

[Anne · Rating 3 out of 5]

Interesting information about how people make decisions, especially medical decisions. You can understand yourself better if you understand your tendency toward Maximal vs minimal, natural vs technology. And also how those things can change over the course of an illness, a treatment, or just over time.

[Helen · Rating 4 out of 5]

A very thorough look on how people make decisions in their medical care and how these decisions effect them. Lots of primary examples, and guidance is given without making a call as to one way being better than another.

[Jim Gleason · Rating 5 out of 5]

husband and wife doctors share essential tools for making medical decisions, cutting through the health care system, the media and gaps in our own reasoning

[Abigail · Rating 2 out of 5]

Quick review: more anecdotal stories than I was expecting; felt at times the stories were repetitive; some good information

[Andy Plonka · Rating 4 out of 5]

How to interact with doctors and medical professionals in the modern world.