The problems faced by medical doctors and automobile mechanics are in some ways quite similarsomething isn't working right and must be fixed. They must both figure out the cause of malfunctions and determine the appropriate treatments. Yet, the mechanic has no need to worry about an automobile's psyche; the specific mechanical factors are the only ones that come into play. In health care, however, the factors influencing outcomes are broader, more complicated, and colored by the underlying psychological factors of those involved. These factors have profound effects. Doctors are often influenced by patients' description of symptoms, yet information is often incomplete or inaccurate or colored by the patient's own experiences. The doctor's own demeanor may greatly affect outcomes, as can the doctor's ability to interpret the ever-expanding medical literature. These underlying influences are often not acknowledged, and yet they can have far-reaching consequences. Acknowledging these psychological factors and learning how to overcome them are the first steps in improving communications between doctors and patients and to improving diagnosis and treatment. Here, the authors offer strategies for remedying the situation and moving forward to a better understanding of doctor-patient visits and their outcomes.
Jessica Leavitt is an attorney who has worked in city government, community college, and non-profit organizations. She is active on state and city boards and commissions, including the California Board of Vocational Nursing and Psychiatric Technicians.
Fred Leavitt is professor of psychology at California State University, East Bay. He is the author of The Real Drug Abusers (Rowman & Littlefield, 2003), Evaluating Scientific Research (2003), and several other books and journal articles. He lectures at hospitals and other venues and offers continuing education seminars for medical professionals.
Table of Contents
Introduction 1. Doctor-Patient Communication 2. Interpreting Medical Information 3. Decisions Overview 4. Biases 5. Medical Diagnosis: The Problems 6. Reducing Diagnostic Errors 7. Prescription for Prescribing 8. Expectation Effects 9. Complementary and Alternative Medicine 10. Patient Outlook and Social Connectedness 11. Healing Environments Appendix 1: Psychiatric Diagnosis Appendix 2: Darwinian Medicine Appendix 3: Wellness Strategies