Living in a box

doi:10.1136/bmj.39184.586725.59

BMJ 2007;334:856 (21 April), doi:10.1136/bmj.39184.586725.59

Views & reviews

Review of the week

Living in a box

David Woods, editor in chief, Rx Communications

dwoods@rxcomms.com

Most medical errors are mistakes in thinking, not in technology,claims a new book, and have a lot to do with the superhumandemands placed on doctors, as well as a measure of arrogance,as David Woods discovers

The first 150 words of the full text of this article appear below.

How doctors all too rarely think, says the noted oncologistand haematologist Jerome Groopman, is, in the words of the cliché,"outside the box." This process starts early in the medicaltraining cycle, he says, with medical students and junior doctorsall too often failing to question cogently, listen carefully,or observe keenly.

What's partly to blame for this, Groopman contends, is today'srigid reliance on evidence based medicine and even, to an increasingextent, on highly sophisticated technology that "has taken usaway from the patient's story." To support this notion he pointsto the sobering statistic that between 1998 and 2002 the numberof computed tomography investigations in the United States increasedby 59%, magnetic resonance imaging by 51%, and ultrasonographyby 50%.

But it's the sensitivity to language and emotion, he believes,that makes for a superior clinician. In fact, he says, technicalerrors account for only . . . [Full text of this article]

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?