pamela hartzband

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‘Your Medical Mind’: Know Thyself, And The Numbers

Drs. Jerome Groopman and Pamela Hartzband are a Longwood-style literary power couple: both on the staffs of Beth Israel Deaconess Medical Center and Harvard Medical School, and widely read in prominent publications from The New Yorker to The New England Journal of Medicine. We spoke this morning about the lessons that can be learned from the vivid stories and psychological insights in their new book.

I derived two takeaways from “Your Medical Mind.” First, you need to be aware of your own biases on medical decisions: Are you a minimalist when it comes to treatment, or a maximalist? Do you tend toward the natural or the technological?

Second, you need to understand decision dynamics that are common to all of us: Our tendency to be influenced disproportionately by what happens to people we know, for example. Our greater willingness to take a risk by not taking action than by doing something.

The federal Agency for Healthcare Research and Quality has just come out with a succinct cheat sheet, a list of questions to ask your doctor, from ‘What is the test for?’ to ‘Are there any side effects?’ I wonder if you could generate on the fly a list of the questions you should ask yourself before you finalize any medical decision?

1. What is my medical mindset?

JG: The questions you refer to from the government are generic questions, and they’re valuable. But the questions you should ask yourself first are: What is my medical mind? Am I a maximalist, so I believe in being proactive, ahead of the curve, doing everything and more? Or am I a minimalist, so I believe that less is more?

Drs. Hartzband and Groopman


PH: And to expand upon that: Are you somebody who likes the latest technology, do you have a technological orientation? Or are you somebody who is more in tune with natural remedies and prefers to go that route?

And finally, are you a believer or a doubter? The believers are people who believe there’s a solution to their problem and they’re going to find it and go with it. And the doubters are people who worry about side effects and unintended consequences, the people who are risk-averse and worry the treatment will be worse than the disease. So that’s your first question: What is your medical mindset?

2. What are the numbers? Continue reading