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When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests

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  • Anonymous

    Posted May 8, 2013

    Improving Patient Care

    Two able Emergency room physicians discuss some of the paths to failures of care in emergency room or other acute care situations. Most such failures are related to systemic errors. A good part of the book is devoted to examples of such paths to failures and then to instruction to patients or their companions on how to avoid such traps.
    The instructions are designed to allow patient to recognize traps of physician focus, care fragmentation, and shallow decisions. While all would know the term cookbook, some might know pathway, but few would know algorithm as they apply to medical care. They then suggest patients respond by questioning the physician. What is the working diagnosis (what do they think I have)? What is planned next and why? Many other questions are suggested. The goal is working collaboratively with their doctor and team to decide diagnosis and care.
    As a physician, I believe, most educated and sophisticated patients enter this arrangement. Such rapport worked for my oncology patients. Some to reach for some feeling of control. Others for understanding and what the authors propose as the goal, better outcomes.
    The proposal is hard to envision in a busy ER. Most patients would find it difficult to get answers from Dr. or staff in a emergency room. It is really aimed at the educated and very strongly focused patient. Some of patients may find it useful, most will find it educational and all find it bit frightening. Less sophisticated readers might get little useful from the book.
    It is a bit laborious to read.

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