Groopman/Crichton on MDs as Cognitive Misers
At the NY Times, Michael Crichton reviews Jerome Groopman's new book, a compilation of his medical essays from the New Yorker. Crichton's review is worth reading, and two themes familiar to Framing Science readers stand out from his discussion of Groopman's view on modern medicine:
a) Just like the public, as part of human nature, Doctors are cognitive misers, constantly looking for short cuts and heuristics to cut down on the complexity of diagnosis and medical decision-making. Relying on heuristics is not always bad, writes Crichton and argues Groopman.
Groopman also discusses physician heuristics -- shortcuts to decision-making that he considers "the foundation of all mature medical thinking," although they too "can lead to grave errors." But Groopman points out that heuristics aren't taught in medical school and are in fact discouraged, in favor of a much more leisurely and extended kind of thinking, typified by Socratic dialogue between students and professors. This means that young doctors enter the hospital knowing little about either the advantages or the disadvantages of heuristics. Take, for example, what psychologists call "availability," the tendency to judge the likelihood of an event by how readily it comes to mind. Thus physicians may mistake symptoms of one disease for those of another disease they've seen more often. Or they may fall prey to "confirmation bias," which leads them to rapidly assemble information into an accurate diagnosis -- or misconstrue the evidence before them.
b) Doctors, like many scientists, remain poor communicators, unskilled at the very important art of doctor-patient communication. Incorporating research in the area, and partnering with social scientists studying the topic, would assist medical schools in improving this aspect of the profession.
Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."
- Upstreamism tasks health care professionals to combat unhealthy social and cultural influences that exist outside — or upstream — of medical facilities.
- Patients from low-income neighborhoods are most at risk of negative health impacts.
- Thankfully, health care professionals are not alone. Upstreamism is increasingly part of our cultural consciousness.
The Bajau people's nomadic lifestyle has given them remarkable adaptions, enabling them to stay underwater for unbelievable periods of time. Their lifestyle, however, is quickly disappearing.
- The Bajau people travel in small flotillas throughout the Phillipines, Malaysia, and Indonesia, hunting fish underwater for food.
- Over the years, practicing this lifestyle has given the Bajau unique adaptations to swimming underwater. Many find it straightforward to dive up to 13 minutes 200 feet below the surface of the ocean.
- Unfortunately, many disparate factors are erasing the traditional Bajau way of life.
Lauren Miranda sent a nude selfie to a boyfriend years ago. Somehow one of her students discovered it.
- Math teacher Lauren Miranda was fired from her Long Island school when a topless selfie surfaced.
- Miranda had only shared the photo with her ex-boyfriend, who is also a teacher in the school district.
- She's suing the school for $3 million as well as getting her job back, citing gender discrimination.
An innovation may lead to lifelike evolving machines.
- Scientists at Cornell University devise a material with 3 key traits of life.
- The goal for the researchers is not to create life but lifelike machines.
- The researchers were able to program metabolism into the material's DNA.
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