How Doctors Think Can Affect Diagnoses

Mary Harding is in the ICU with hypertension and fluid in her lungs and a nervous "next of kin."

Luckily, Mary is a mannequin — part of an exercise designed to make doctors think. That's something Dr. Jerome Groopman says they don't do enough, CBS Evening News anchor Katie Couric reports.

"I think it's time for a national conversation. Fifteen to 20 percent of all people are misdiagnosed in the United States," Groopman says. "In half of those cases it causes serious harm — and sometimes death."

A professor at Harvard Medical School, Groopman is trying to reduce those numbers with a new book, "How Doctors Think." In it, he spills some of the dirty little secrets of doctors and what dictates their diagnoses.

Read An Excerpt Of "How Doctors" Think"
"One of my misdiagnoses was a woman who I found irritating," Groopman says. "And we all have people that irritate us. She was complaining of discomfort under the center of her chest. And I basically closed my mind. I gave her antacids and stopped thinking. And it turned out that she had a tear in the aorta; the major vessel that leaves the heart."

Groopman admits that patient died.

"If the doctor doesn't like you, he or she closes their mind off. It's a set-up for misdiagnosis," Groopman says.

Doctors not only bring their personal feelings to the exam room, Groopman says, they carry around plenty of preconceived notions in their doctor's bags, too.

"Patients need to tell the doctor, 'Don't stereotype me,'" Groopman says.

Leslie Bovenzi, 44, is a mother of three who went to her doctor with persistent diarrhea and fatigue. After a series of tests, she was told, "It must be stress; it must be your inability to deal with raising your family and the stresses that come with that."

It was three years before it was discovered she had a cancerous tumor the size of a baseball in her small intestine.

"The most common stereotypes occur in women who are entering middle age and their symptoms are attributed — snap judgment — to stress, anxiety or menopause," Groopman says.

So his prescription for patients? He says, turn the tables and question your doctor.

"A patient can say, 'What else could it be?' especially if it's not getting better. Or, 'Could two things be going on at the same time?'," Groopman recommends.

Excerpts from Dr. Groopman's interview with CBS Evening News anchor Katie Couric:








He adds that you should never be afraid to tell your doctor what's worrying you the most. "Then the doctor becomes more sensitive to what the person is feeling about his or her body," Groopman says.

But there are orders for his fellow doctors, too. He hopes his book will make them change the way they see their patients — and themselves.

"We need, as doctors, to think better in an open way — to listen more deeply and to really change the way we make diagnoses," Groopman says.



Do you have a general question for Dr. Groopman? If you want general advice — not a specific diagnosis — e-mail us your question. We will post some of the answers next week.

Click here to read Dr. Groopman's articles.

•To read an excerpt of "How Doctors Think," click here.
  • Melissa McNamara

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