Review of “When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests”

It’s been a really long time since I voluntarily picked up a book, especially a non-fiction one, since I now do most of my readings from Twitter and newspaper. Having said that, what initially made me to choose read “When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests” was very unique – I wanted to read this book because after following Dr. Leana Wen (@DrLeanaWen) on Twitter, I had found her views in medicine rational and caring for patients. In fact, I became a follower for her even before this book was released, but I made a promise to myself that I will get around to do reading at some point. There is another author of the book by the way – Dr. Joshua Kosowsky – and because Dr. Kosowsky has more experiences than Dr. Wen, he provides a slightly different (but still related) perspective that was good to read.

Who Are These Doctors and What Does This Book Mean?

So, I provided a little bit about their background in the last paragraph. You can find more about them from the publisher or Amazon websites, or even read a Wikipedia page (I found this while reading this book!). What I CAN tell you that you won’t easily find on the web is that these two physicians are some of brightest and thoughtful physicians you will meet. I’m saying this out of true honesty – there are different kinds of physicians in the field, just like there are various levels of salesmen or executives in businesses and marketing. These two physicians really know what they talk about, and frankly, I am impressed by their decision to come forward with this book, which certainly will have met with some skepticisms from other practicing physicians in the field.

What this book means is really a way to change the perspective about the medical field, not just in terms of fiscal evaluation or quality assessment, but rather, in the idea of medicine as a whole. It’s about how physicians should make diagnoses – but it is also about patients and what they can do to achieve it. Interestingly enough, this book talks about all the problems about healthcare without actually touching them until the very end – and how does this happen?

Doctor Office 1
Image is credited to Subconsci Productions.

This Book Will Open Your Eyes on What Diagnosis Really Is

Unlike other medical-related books that focus on one aspect of healthcare issues, such as cost or affordability (i.e. insurance coverage or lack of it), this one is about something that relates to everyone: diagnosis. Why this is so important is that nearly all the problems in healthcare now stem from diagnosis. Take costs for example – ordering unnecessary CT, X-rays, or blood tests all sum up in the end of high costs for healthcare but they occur from poor diagnosis that physicians make in concerns of malpractice lawsuits. It’s not just physicians though; some patients actually want all the tests done to be sure that they are clear of diseases – but in the end, do they really know what they have? This idea of “ruling out” approach has driven healthcare costs to the level we live now.

Now, I am also going to throw in my own two cents on this discussion of diagnosis. It has been said that a lot of decision-making that physicians do is quickly on going through the “list” of possible diseases based on patient’s symptoms and eliminating ones that do not match correctly. In other words, this checklist approach has worked because it is fast, efficient, and enables physicians, who are sometimes under the pressure of hospitals to see many patients, to spend minimum necessary time but still care for them. This is especially true for primary care physicians in rural areas (I’m sure you’ve heard of this too – it’s in the news quite a lot), but when you read this book, you are going to learn that this method of elimination runs into serious risks when it is combined with ordering tests because it may not actually do any benefit – and in fact, do harm – to the patients.

This book does not deny the benefits of elimination of diseases. Rather, it emphasizes that there is something more important, and that is the interaction of patients and physicians to come up with a mutual, rational, and realistic diagnosis. It’s an idea that makes sense, helps patients and physicians, and most importantly, can lead to the improvement of the patients.

Why I Think You Should Read This Book

A lot of what I mentioned so far has not done too much with the “meat” of the book. But, that was intentional – majority of the book touches on stories of patients that involve personal opinions/voices by two physicians, so instead of spoiling the fun of reading them, I am going to ask you to do it yourself. There are also sections at the end of the book for helping you to become better at improving discussion with your physicians. It’s an useful exercise to try, and I can definitely see that the authors put a lot of time and efforts to put this through.

Personally, I want to leave you with one really important point about this book and that is to have an economic perspective view on medicine. I don’t mean you should become a politician and judge medicine by money – if you want to, that’s fine, but that’s not what I mean. What I actually intend to say is that just like how you wouldn’t buy an expensive food from grocery store without knowing why you need it or why it is worth the price, you should have that same skepticism with your visits to hospitals or doctors’ offices. Be respectful and understandable of your doctors, but at the same time, you have to realize that from diagnosis to tests, you need to speak up and voice your opinion. This constant “I’m going to just follow what my doctor says to do” will not help your hospital bill, and based on this book, it will not necessarily make you become healthy.

And that’s why I want you to read this book – because once you start reading, you are going to see why you have to become an active partner in your own health and diagnosis. It’s your life, your health, and your body, so why not become actively engaged about it? It’s the right thing to do.

What do you think?

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