Why patient stories actually matter

Most of our medical visits start with some variation of this opening question: “Why are you here today?” Connecting with and understanding patients thus requires doctors to listen to what’s called the patient narrative.  The importance of really hearing this narrative is beautifully described by U.K. physician Dr. Jeff Clark, writing in the British Journal of General PracticeBut the problem, as Dr. Clark reminds his peers, is that patients and doctors see the world in very different ways.  He also warns that the stories patients tell their physicians about why they’re seeking medical care may all too often be seen by doctors as merely a time-wasting distraction from “getting to the bottom of things.

The urge to get to the bottom of things may also help to explain what’s known as “The 18-Second Rule”.
Continue reading “Why patient stories actually matter”

The ’18 Second Rule’: why your doctor missed your heart disease diagnosis*

by Carolyn Thomas  @HeartSisters

The trouble with Dr. Jerome Groopman‘s book, How Doctors Think, is that the docs who really need it won’t read it.  But patients will, thanks to word-of-mouth buzz since it was published in 2007.

As a patient who has experienced a life-threatening misdiagnosis while having a heart attack, my own favourite part of the book is Dr. Groopman’s review of physicians who take cognitive shortcuts during patient visits.

This means that doctors can jump to conclusions about diagnosis or treatment options, and then can’t budge even when contradictory evidence subsequently emerges. “Blame the 18 Second Rule!” advises Dr. Groopman, professor of medicine at Harvard.

“That’s the average time it takes a doctor to interrupt you as you’re describing your symptoms. By that point, he/she has in mind what the answer is, and that answer is probably right about 80% of the time.”     Continue reading “The ’18 Second Rule’: why your doctor missed your heart disease diagnosis*”