Medicine & Culture

I was reading a review of two recent books about the history and culture of medicine (Carrying the Heart by F.Gonzalez-Crussi* and The Deadly Dinner Party by Jonathan Edlow--both of which sound great), and found the long introductory section by the reviewer, Dr. Jerome Groopman, to be enlightening about the current culture of medicine.  Dr. Groopman describes medicine today as a combination of an industrial and commodity model:

" But only recently has medical care been recast in our society as if it took place in a factory, with doctors and nurses as shift workers, laboring on an assembly line of the ill. The new people in charge, many with degrees in management economics, believe that care should be configured as a commodity, its contents reduced to equations, all of its dimensions measured and priced, all patient choices formulated as retail purchases."

(This was the second article I read this morning that noted the way in which the industrial model is being applied to something outside industry--the first one was this one on education that I posted here.)

Dr. Groopman also describes cognitive errors in diagnosis and mentions three main sources of error:

" 'anchoring,' where a person overvalues the first data he encounters and so is skewed in his thinking; 'availability,' where recent or dramatic cases quickly come to mind and color judgment about the situation at hand; and 'attribution,' where stereotypes can prejudice thinking so conclusions arise not from data but from such preconceptions."

That reminded me of the article on anchoring, "Irrational Decisions" which Kat recently posted on facebook.

*part of Dr. Groopman's assessment of Carrying the Heart: "…a sharp departure from medicine as a cold world of clinical facts and figures. Rather, [Gonzáles-Crussi] asks us to return to a view of the body not as a machine but as a wondrous work of creation, where both the corporeal and the spiritual coexist."