It is impossible to estimate how many decisions a doctor has to make on any given day in practice. There is diagnosis, prognosis, tests, treatment, dosage, and a thousand other questions to be answered from the moment they enter their building to the moment they leave. You pair that with the high demands placed on them from patients, families, insurance companies, business partners, trainees, legislation, and the general public and it is no wonder that many have tried to standardize the way they work, train, and think as physicians. In the same given 24-hour day they somehow have to work faster, see more patients, cut costs, decrease tests, and improve results.

Once you grasp the demands being placed it is easy to understand why “Most physicians already have in mind two or three possible diagnoses within minutes of meeting a patient” or why a doctor could appear short or distracted. Groopman’s case-based style of writing illuminates both those expectations and the systems in place that are masking or delaying an accurate diagnosis in the name of efficiency.

Written as a way of helping patients understand ‘How Doctors Think’, Jerome Groopman’s book is meant to be a window into the mind of a physician, a way of giving the patient questions they can ask to help their doctor step outside of those standards of thinking that are perhaps getting too ingrained into the system, and an honest reflection as a physician into how these methods might be improved.