What Patients Say What Doctors Hear

Can refocusing conversations between doctors and their patients lead to better health? Despite modern medicine’s infatuation with high-tech gadgetry, the single most powerful diagnostic tool is the doctor-patient conversation, which can uncover the lion’s share of illnesses. However, what patients say and what doctors hear are often two vastly different things. Patients, anxious to convey their symptoms, feel an urgency to “make their case” to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously. Though the gulf between what patients say and what doctors hear is often wide, Dr. Danielle Ofri proves that it doesn’t have to be. Through the powerfully resonant human stories that Dr. Ofri’s writing is renowned for, she explores the high-stakes world of doctor-patient communication that we all must navigate. Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us.

“A fascinating journey into the heart and mind of a physician” that explores the doctor-patient relationship, the flaws in our health care system, and how doctors’ emotions impact medical care (Boston Globe) While much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. Physicians are assumed to be objective, rational beings, easily able to detach as they guide patients and families through some of life’s most challenging moments. But understanding doctors’ emotional responses to the life-and-death dramas of everyday practice can make all the difference on giving and getting the best medical care. Digging deep into the lives of doctors, Dr. Danielle Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Ofri offers up an unflinching look at the impact of emotions on health care. Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. Ofri also reveals that doctors cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness.

Medical mistakes are more pervasive than we think. How can we improve outcomes? An acclaimed MD’s rich stories and research explore patient safety. Patients enter the medical system with faith that they will receive the best care possible, so when things go wrong, it’s a profound and painful breach. Medical science has made enormous strides in decreasing mortality and suffering, but there’s no doubt that treatment can also cause harm, a significant portion of which is preventable. In When We Do Harm, practicing physician and acclaimed author Danielle Ofri places the issues of medical error and patient safety front and center in our national healthcare conversation. Drawing on current research, professional experience, and extensive interviews with nurses, physicians, administrators, researchers, patients, and families, Dr. Ofri explores the diagnostic, systemic, and cognitive causes of medical error. She advocates for strategic use of concrete safety interventions such as checklists and improvements to the electronic medical record, but focuses on the full-scale cultural and cognitive shifts required to make a meaningful dent in medical error. Woven throughout the book are the powerfully human stories that Dr. Ofri is renowned for. The errors she dissects range from the hardly noticeable missteps to the harrowing medical cataclysms. While our healthcare system is—and always will be—imperfect, Dr. Ofri argues that it is possible to minimize preventable harms, and that this should be the galvanizing issue of current medical discourse.

From a doctor Oliver Sacks has called a “born storyteller,” a riveting account of practicing medicine at a fast-paced urban hospital For two decades, Dr. Danielle Ofri has cared for patients at Bellevue, the oldest public hospital in the country and a crossroads for the world’s cultures. In Medicine in Translation she introduces us, in vivid, moving portraits, to her patients, who have braved language barriers, religious and racial divides, and the emotional and practical difficulties of exile in order to access quality health care. Living and dying in the foreign country we call home, they have much to teach us about the American way, in sickness and in health.

Discusses how to avoid harmful medical mistakes, offering advice on such topics as working with a busy doctor, communicating the full story of an illness, evaluating test risks, and obtaining a working diagnosis.

From a young age we are taught to seek guidance from those who are more knowledgeable than ourselves. Doctors, surgeons, and nurses have all been educated in their specific fields, but this doesn’t always make them experts. Over the past five years, Theresa Errante-Parrino has dealt with cancer. Here she records her breast cancer story, sharing behind-the-scenes details of her personal experiences. From dealing with difficult doctors to adjusting to a new lifestyle and new routines, the author gives insight into what having cancer is really like. Having learned from her own trials, Errante-Parrino hopes to encourage others to take control of their medical situations as their own advocate, speaking out when they believe something isn’t going to help them. With formal medical training as a certified medical assistant, pharmacy technician, paramedic, and X-ray technician, Theresa has the knowledge to recognize when medical conclusions are not truthful or correct. Educate yourself and raise your voice, because no one knows your body like you do.

A “finely gifted writer” shares “fifteen brilliantly written episodes covering the years from studenthood to the end of medical residency” (Oliver Sacks, MD, author of The Man Who Mistook His Wife for a Hat) Singular Intimacies is the story of becoming a doctor by immersion at Bellevue Hospital, the oldest public hospital in the country—and perhaps the most legendary. It is both the classic inner-city hospital and a unique amalgam of history, insanity, beauty, and intellect. When Danielle Ofri enters these 250-year-old doors as a tentative medical student, she is immediately plunged into the teeming world of urban medicine: mysterious illnesses, life-and-death decisions, patients speaking any one of a dozen languages, and overworked interns devising creative strategies to cope with the feverish intensity of a big-city hospital. Yet the emphasis of Singular Intimacies is not so much on the arduous hours in medical training (which certainly exist here), but on the evolution of an instinct for healing. In a hospital without the luxury of private physicians, where patients lack resources both financial and societal, where poverty and social strife are as much a part of the pathology as any microbe, it is the medical students and interns who are thrust into the searing intimacy that is the doctor-patient relationship. In each memorable chapter, Ofri’s progress toward becoming an experienced healer introduces not just a patient in medical crisis, but a human being with an intricate and compelling history. Ofri learns to navigate the tangled vulnerabilities of doctor and patient—not to simply battle the disease.

On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong—with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can—with our help—avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.

“A gorgeously written primer for anyone who has ever been (or ever will be) a patient . . . The book soars.” —The San Diego Union-Tribune Jamie Weisman was a patient long before she was a doctor. She was born with a rare defect in her immune system that leaves her prey to a range of ailments and crises and that, because it is treatable but not curable, will keep her a patient for life. In this probing and inspiring book, she brings her sojourns on both sides of the doctor-patient divide to bear on the issues of the flesh that preoccupy us all. It is a worthy addition to the best that has been written about our physical selves, a meditation on our extraordinary powers of healing and the limitations that leave intact the miracle and tragedy of being.

"Patients, anxious to convey their symptoms, feel an urgency to "make their case" to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously. ... Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us."--Jacket.