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

Written by Jerome Groopman and Pamela Hartzband

Narrated by Linda Emond and Cotter Smith

Cutting through the confusion caused by the healthcare system, the media, and gaps in our reasoning, the bestselling author of How Doctors Think gives listeners essential tools for making the medical decisions that best suit their own needs.

“This important and riveting book could change—and perhaps even save—your life.”
—Daniel Gilbert, author of Stumbling on Happiness

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.

• Language: English
• Publisher: Simon & Schuster Audio
• Release date: Sep 20, 2011
• ISBN: 9781442347298

Jerome Groopman

Jerome Groopman, M.D., holds the Dina and Raphael Recanati Chair of Medicine at Harvard Medical School and is chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston. A staff writer for The New Yorker, he is the author of How Doctors Think, The Anatomy of Hope, Second Opinions, The Measure of Our Days, and other books.

Reviews for Your Medical Mind

[dhealy_21 · Rating: 2 out of 5 stars]

Doesn't live up to its title

[glennbell_1 · Rating: 3 out of 5 stars]

The author compiles a number of cases in which the patient is faced with a number of options for treatment of the disease or condition. The options are discussed and personal preferences are examined. Such concepts as minimal or maximum care, natural or high tech care, and quantity versus quality of life are discussed. No right or wrong answers to these value based choices are proposed. The book provides food for thought.

[judithrs · Rating: 3 out of 5 stars]

Your Medical Mind; How to Decide What is Right for You. Jerome Groopman and Pamela Hartzband. 2011. A husband and wife team study the way people make decisions relating to their healthcare and their death, and the way doctors present the options for various treatments. Basically they find that people make healthcare decisions the way they make other decisions. Some people carefully study all available options, some depend on what the doctors? advice, others listen to friends; and all make judgments based on their previous experiences. Doctors usually suggest the treatments with which they have the most experience. And there is a discussion of several formulas used by heath personnel to evaluate the quality of life that can be expected as the result of specific treatments. I suspect this is where the fear of ?death panels? comes from. Read this if you are concerned about your future medical care.

[bragan_8 · Rating: 4 out of 5 stars]

I think the subtitle of this book my be a little bit misleading. If you're hoping for detailed advice on how to navigate the healthcare system and how to decide on specific medical treatments, you may find this isn't quite what you're looking for. It does have some potentially useful advice on different ways to think about those decisions, and on evaluating medical statistics, but mostly its focus is on the general importance of tailoring healthcare to the individual patient, and on the difficult and complicated nature of doing so.The authors' main contention is that everyone, doctor or patient, has their own set of values when it comes to making their healthcare choices. Some people want the most aggressive healthcare possible, treating even vague potential problems as soon as there's any reason to think they might become an issue. Others prefer a more minimalist approach, preferring not to intervene in their body's workings without a truly compelling reason to do so. Groopman and Hartzband believe very firmly that it's important to take these mindsets into account and for doctors to respect and work with them. They also point out that while science can give us statistical information about which treatments are most likely to have which effects, only the individual can make value judgments about those effects. For instance, a drug's potential side effects may be quite acceptable to one person, but deeply problematic for another. There are a lot of things, of course, that make all this decision-making intensely complicated. There can be vast amounts of uncertainty about what is likely to help, what is likely to hurt, and when it's best simply to do nothing at all. People are often very bad at predicting how possible medical outcomes will affect their quality of life. And then there are all the complex ethical questions of what to do when a patient isn't in a position to tell anyone what they want. (The book cites some really rather depressing studies and anecdotes suggesting that advance directives, which are supposed to make decision-making easier in a crisis, often really don't.)All of this is illustrated with lots of personal stories, because, as the authors point out, stories have much more of an influence on us than statistics do. Which, of course, can also be a problem, as hearing one horror story -- or success story -- about a particular treatment can sway our decision-making far more than is necessarily justified.The book makes some really good and thoughtful points on what is surely an extremely important topic, and uses science as well as stories to back up its points. Generally, it's good, and it's definitely worth reading. But I do have two quibbles with it.First, in all these discussions of people making healthcare choices, some very important practical considerations seem to get left out. We read about a guy debating which of two top specialists to see, one of whom is apparently in a different part of the country than he is, but there aren't really any stories about people who have to deal with limited choices based on what their insurance will cover, or whether they have the wherewithal to travel, or live in a rural area with a limited choice of doctors. Maybe an in-depth discussion of this kind of thing is outside the scope of the book, but it would have been nice to have at least some acknowledgment that when it comes to healthcare, there are considerations other than medical statistics and personal preference that most of us also have to deal with.The second quibble is a rather bigger one, namely that the authors don't draw a clear line between medical treatments that are based on some degree of actual evidence, however messy and uncertain that evidence may be, and pseudo-scientific alternative medicine treatments that have no valid basis at all. While that's not a subject they go into in any depth, they do seem, in their enthusiasm for respecting patients' own values and mindsets, to be positioning those two things as equally valid ends on a spectrum of preference, which I really don't see as justifiable.

[nyiper · Rating: 5 out of 5 stars]

Just terrific---makes you "start" thinking. I was listening to the audio version and really need to listen to it all again to make more of it stick in my head! Using actual patients to help emphasize the decisions one faces is what it is all about ---the subtitle "How to decide what's right for you" makes perfect sense. Medicine is almost never black and white no matter how much we might all wish for easy answers to usually complex problems.

[bell7_1 · Rating: 5 out of 5 stars]

Chances are, you don't fully grasp your own biases in making medical decisions. Drs. Groopman and Hartzband discuss psychological aspects of decision-making such as risk-aversion, framing statistics, and the availability of stories of others who have had the disease, using stories of patients to illustrate how complicated finding the "best" answer can be.I have a much greater understanding of the complexity of patient care after reading this book. Doctors have a variety of opinions and understanding of the best treatments. So do their patients. And sometimes, there is no clear-cut answer. Numbers drive decisions more and more - pushes for efficiency, or insurance companies covering one treatment and not another. Patients vary in what types of treatment they want, and can change their mind in the midst of treatment making following advance directives difficult. I discovered that I'm a minimalist, in their phraseology: one who likes to take the least amount of medication possible, which helped me understand why it took me so long for one of my doctors to convince me to take a medication I now swear by, and why I like that my primary care's default response is a "wait and see" approach. I'm still young and fairly healthy, but I will want to revisit this again and will definitely have it in mind if and when I need treatment for anything in the future.

[garysmeade · Rating: 4 out of 5 stars]

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.