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Overcoming Bias Commenter's avatar

There's a recently released book that some of the posters to this blog might find interesting. I just read Jerome Groopman's book, How Doctors Think. Groopman describes some of the common thinking errors that physicians (like all of us) are prone to, using some stunning case histories to illustrate his points. I suspect that there's a lot of variation in how much training in research design and statistical analysis that physicians receive, which would affect how sophisticated their understanding of basic ideas (such as the limits of correlational research to demonstrate causation) is. What Groopman emphasizes is that doctors are taught nothing about the cognitive errors that contribute to medical misjudgments and misdiagnoses. In his book, Groopman laments the fact that doctors are not routinely taught about cognitive errors and ways to dminish them as part of their medical training.

Groopman discusses the role of "managed care," and the use of decision-trees, etc. as additional contributors to a lack of critical thinking by physicians. He also suggests what kinds of questions patients can raise to essentially help their doctors avoid some of those errors. Although these questions won't "cure" the problem, they are a beginning - and Groopman urges patients who don't receive satisfying answers from their doctors to seek another physician.

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Overcoming Bias Commenter's avatar

Retired Urologist,

Thank you *very* much for your thoughtful reply. But I want to clarify one thing. I now understand that it is the body, not the chemo, that gets rid of the very last little bits of cancer. That is not, however, exactly the same statement as saying that chemo can do no additional good once the tests and scans have come back clean: it seems theoretically possible that there could still be some bits of cancer that are small enough not to show up on scans but that chemo can still be useful in eliminating, even if they are not the very last bits. Are you saying that this is false as a matter of fact, and that it is an established result that once you have clean scans the "magic level" has already been reached and chemo can do no additional good?

Thanks again!Dave

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