When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests
by Leana Wen, MD and Joshua Kosowski, MD
When writer Leana Wen’s mother was diagnosed with cancer while Wen was in medical school, she was horrified by how impossible it was to navigate the system, even after years of being part of it. It also lead to Wen becoming an outspoken advocate for patient empowerment.
“Seeing how (my mother) was treated by her providers gave me a whole new understanding of what it meant to be a patient, and why it’s so important for both patients and physicians to question this cookbook approach to medicine,” Wen writes.
The authors Wen and Kosowski define “cookbook medicine” as a rote and formulaic approach to practice. Better care begins with a better partnership between physician and patient, and that was their goal in writing the book.
“Our book is not about cutting tests for the sake of reducing cost; it’s about getting to the right test and arriving at the right diagnosis,” they write. The book reveals “a fundamental flaw in the way the system has evolved and how doctors are trained.”
“We are inviting you to become a partner in the most important part of your healthcare: your diagnosis,” the authors exhort readers in the introduction.
Wen and Kosowski are both ER doctors, and all of the case studies in the book came straight from their work at Boston-area teaching hospitals. Each of the cases presented exemplifies the importance of being an advocate for your own health. Their main point is that patients need to ask more questions and doctors need to listen more carefully in order to come more quickly to the correct diagnosis, which they argue is the most important factor in quality care.
‘“What hope is there when medical students are taught more and more about rules and recipes and less about listening to patients and making diagnoses?”
Taking (and giving) a good patient history is key to success.
While ostensibly written for patients and physicians, the book feels a little like a health care textbook for being a good patient-- in a good way. Each chapter includes boxed tips on how to be a more informed patient, and ends with a review of the major points, and even exercises and worksheets. The “Action Tips” throughout the book include things like, “Always answer your doctor’s questions honestly,” and “If your doctor keeps asking you closed-ended questions, answer them, but then ask him questions back. And attach narrative responses.”
Thanks to Wen and Kosowsky, patients and physicians have now have a comprehensive guide to better care.