How Doctors Think Can Affect Diagnoses
Dr. Jerome Groopman Says Physicans Bring Their Personal Biases To The Exam Room
-
Play CBS Video
Video
Patience For Patients
A new book by a Harvard professor claims that doctors' personal feelings and preconceived notions can affect their diagnoses of patients. Katie Couric has more details.
-
Video
A Doctor's Emotional Baggage
Only On The Web: Dr. Jerry Groopman tells Katie Couric that if a doctor dislikes a patient, there is a chance that a misdiagnosis can be made because of personal feelings.
-
Video
If A Doctor Likes You Too Much
Only On The Web: Sometimes, when a doctor gets too attached to a patient, he or she may not give the best care possible. Dr. Jerry Groopman explains why.
-
-
Photo
Dr. Jerome Groopman says doctors need to do a better job of listening to their patients. (CBS)
-
Photo
"How Doctors Think" by Dr. Jerome Groopman (CBS/Houghton Mifflin Company)
-
-
Interactive
HealthWatch
Explore health issues including AIDS, cancer and antibiotics.
-
Quiz
Medical Exam
Give your brain a checkup with these health quizzes.
-
Video Archive
Eye On Health
CBS News medical correspondent Dr. Jon LaPook examines various health issues and treatments.
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.
"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."Read An Excerpt Of "How Doctors" Think"
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:How To Be A Better Patient
Doctors' Pet Peeves
Disliking The Sickest Patients
If The Doc Likes You Too Much
Doctors' Emotional Baggage
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.
© MMVII, CBS Interactive Inc. All Rights Reserved.
Video and Galleries from CBS Evening News
- Latest in CBS Evening News
- MJ Tributes, From Pop Icons To Global Fans
- Serial Killer Shatters S.C. Town's Psyche
- National Mall Showing Its Age
Read An Excerpt Of "How Doctors" Think"
How To Be A Better Patient



By the time she was 2 she had several "infected lymph nodes" drained or removed. Last resort I took her to Boston Children's Hospital. There was a massive panic- she had TB! TB- highly contagious & deadly!! Turns out all the previous times her nodes were drained or removed no one bothered to send them for lab tests! ***!
Thankfully after major surgery & a year of medication she lived to tell. How dangerous- not only to her & me, but to the general public- for all those prior pediatricians to give substandard care because of their personal bias against young single mothers!!!! And this was back before everyone was litigation crazed or else I may have jumped on the mal-practice band wagon!
"These are the two snakes fastened around Mercury's staff with which he demonstrates his great power and changes into whichever form he wishes.. When these two are placed together in the vessel of the Dead Tomb, they bite one another cruelly. Through putrefecation they lose their first natural forms to take on a new nobler form.. The reason why I make you draw these two seeds in the form of thei dragon is because their stink is very great and their poison... (Nicolas Flamel, Chymische Werke, Hamburg Edition, 1681)
This is where modern medicine comes from, they poison you to fight poison, they think two negatives = a positive... QUACK QUACK QUACK
We have suffered from misdiagnoses as well as hurried surgery.My advice--CHANGE the doctor who rushes you.
Next advice is to check their education/training.Board Certification tells you that they passed--but they may have missed one out of four questions.In other words,they did not know the answer to one question out of four.
If you do not get better soon(within 2 weeks),try another doctor--DO NOT RISK YOUR LIFE.
Bottom line they don't care. Patient beware.
Why not spend a day in a family physician and internists office. Just try- also, come back at the end of the month when we get the receivables and expenses. May be the university and you can start a charity, shell some cash out.
Day in and day out you hear- medical expenses are on the rise- true . Where did the money go, check out the stocks of Cigna, aetna , wellpoint united health care. See the CEO bonuses. see what GE and xerox are profiting and check out the pharma porfits and the pharmacy profits- check it out
And well- the physician- we are fighting 5- 17 % cut in reimbuirsement.Besides stone walling , lack of medical necessity and prior authorisations etc etc etc ..........Then the DEA and OIG and the state physician boards and lawyers and local media????
And What about Patient responsibility - dO THEY HAVE ANY. dO THE MEDIA AND iNSURANCE COMPANIES HAVE ANY RESPONSIBILITY?
NO ITS THE DOCTOR- FORGET ALL THE GOOD THEY DO FOR A 99213 VISIT PAID 25- 35 $$$
AND YOU PROFESSOR AT HARVARD Groopman YOU SHOULD BE ASHAMED FOR NOT BEING TRUTHFUL AND FACTFUL. MAKE SURE YOU SET UP YOUR KIDS AND GRAND KIDS A GOOD TRUST FUND WITH THE SALE OF YOUR BOOK , WHILE WE DO CHARITY AND DEDICATED WORK AND FLUSH YEASR OF HARD WORK AND EDUCATON DOWN THE TOILET!!!
misdiagnosis and no diagnosis is medical malpractice. doctors are no better than anyone else running a BUSINESS! that's what it is in our lifetime---a BUSINESS! doctors are not out to save patients, they are out for their $$$ POCKET, including you groopman. why should a doctor who hurts patients be any different than the guy who steals a loaf of bread and hurts someone in a store robbery? go to jail, get your card, doctors. you all are no different when you mess up someones life compared to a robber or someone who is convicted of manslaughter. it is MALPRACTICE WITH CAPS!!!
leidhold
you want to pass the responsibility onto everyone except the medical community. blame everyone else except your profession, bondmd1.
DENIAL...
you need a therapist, bondmd1 and every dr like you who denies and hurts patients.
leidhold
I agree with the folks it's about rushing people through and/or greed. And THAT is where many malpractice originate - rubbish doctors. Maybe reform has to take place as much on the supply side as well as it has to on the 'tort' side. Anybody who wants to protect quacks is against protecting the quality of human life.
In short, EVERYBODY has responsibility and that includes voluntary diseases (STDs, smoking that causes cancer, et al), I regret to say. I have sympathy for those who get it, but maybe if somebody put their foot down, people would respect it, not get it, and be able TO live. It seems I have learned something in this lifetime after all... and if I die trying to get back into shape (lack of exercise, not eating junk food), y'all can heckle my demise too. At least I'm trying to do right these days.
I'm glad they found it was a thyroid problem. Any doctor worth their cred will do a sufficient battery of tests to rule out physical malaise rather than summarily saying "Do this, now pay me $400 and go on your merry way."
On a tangential facet, I once had a counselor who said the same thing (have ***). It's funny. Especially in "liberal" sects (I don't know of any right-wing-leaning counselors); apparently it's "helpful" to suggest something but then not even offer follow-up advice, tips, or assistance as to go about getting it. In short, they have no clue and prefer to throw out anything that makes them feel better. Junk doctoring. Junk advice. Junk people who get paid too much for blowing people off. (uh, not like that... sending them on their way with junk advice.)
Doctors are amusing and, ultimately, people won't care. It's as simple as that. :) The difference is, people should. We'd be better off as communities and as a country for it. And a world too.
how about the true patient who gets meds thrown in their face wihtout getting any side effect knowledge from the so-called educated dr's. the dr's who supposedly go to school for so many years and then they complain that they have racked up $$$ for expenses. ha...
give it a break.
dr's are no different than a garbage man who owns his own business or a convinience store owner. all in BUSINESS making MONEY for THEMSELVES.
at least these guys at 7/11 and the garbage man don't mess with or kill people on a daily basis because of prejudice and ignorance. oh, pompousness, too!!!
dr's need to realize that they are there for the patient, not their dang bank account!!!
DO YOUR JOB, DR'S!!! STOP JUDGING. sooner or later, patients are going to stick it to you bad dr's.... STOP THINKING ABOUT YOUR BANK ACCOUNT AND START THINKING ABOUT SAVINF LIVES!!!
Its common sence you dont need numbers.
and pretty much 95% of statistics are completely worthless anyway.
After seeing many things first hand, you start to question things much more. I know a few doctors that should'nt be operating on people. Along with others that are just plain bad family docs. Dont go anywhere unless you know things about the doctor.
Question things.
One thing that is hard tho as a doctor is being over cautious or under cautious. I work in radiology and we have some doc's that order exams on basically every patient they see(for some reason these seem to be the female doc's, probably just chance but still) and some that rarely order exams. I am not positive the actuall statistic but something like 75% of chest and abd-pelvis CT exams are negative.
you try to find a mix of diagnosing things on your own and ordering radiologic exams. (PS one of the largest money making things in a hospital is radiology)
If the Doc really dosent know how to diagnose things very well they tend to order many exams and hope someone else can tell them what is wrong with the patient.
and if they are just in it for money they will prob send you all over the place for unessary exams.
overall tho most doc's are good people who just try their best. but everyone wants things to be perfect and it puts them in a rough spot.
i am not laughing. dr's have wrecked my life!!!
my sons life and my husbands, too! i have no sympathy and/or empathy for groopan or any other dr. they all want MONEY!!! MORE $$$$$.
they should first and foremost do THEIR JOB.
btw, good poeple, as you say, don't make good dr's. a robber can be a good person, but hardup for food or money. our society needs to change the way medical care is delivered, POORLY!!!!
leidhold
-
by mdherder
March 20, 2007 1:00 PM PDT
- It's interesting to read the complaints about the horrible care received by leidhold and others. Why do I get the feeling these posts come from people who pay nothing for health care? Taking care of the uninsured is part of the mission in teaching hospitals, but this population takes no responsibility as patients. They ignore you when you tell them they need to take their medication which they get for free, and then blame you when they don't improve. They skip appointments and blatantly use the ER for non-life threatening care. A little individual responsibility by the patient is required for a doctor to be successful. In response to the person who says we're all about money...we legally have to pay interpreters to come in if the pt. doesn't understand English. With ever shrinking reimbursements for the underserved pts., we end up $20 in the hole for each visit, & then get stuck paying for the no-show pts. With all the paperwork CMS requires, we can spend 30 min. doing paperwork each office visit. Because of frivolous lawsuits, malpractice insurance can cost $500,000-$1 million a year out of that big pool of money we allegedly make. There are bad doctors, but plenty of irresponsible patients. And here%u2019s some bad news. Over half of physicians, when asked if they would recommend their children practice medicine, said no. It%u2019s predicted there will be a shortage of physicians by 2020. Can%u2019t wait to hear the complaints when you have to wait months to get into a doctor.
-
Reply to this comment
-
See all 19 Comments