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How Doctors Think: Clinical Judgment and the Practice of Medicine | 
 enlarge | Author: Kathryn Montgomery
Publisher: Oxford University Press, USA
Category: Book
List Price: $39.99
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Avg. Customer Rating:  7 reviews
Sales Rank: 97781
Media: Hardcover
Edition: 1
Number Of Items: 1
Pages: 256
Shipping Weight (lbs): 1.3
Dimensions (in): 9.4 x 6.3 x 0.9
ISBN: 0195187121
Dewey Decimal Number: 610
EAN: 9780195187120
ASIN: 0195187121
Publication Date: November 2005
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Product Description
How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness.
How Doctors Think is divided into four parts. Part one introduces the concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment.
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| Customer Reviews: Read 2 more reviews...
 Worth reading carefully May 23, 2008
This is an incisive, and personal, analysis of how physicians think. It analyzes the foundations and processes behind physician's decision making, and their relationship to the patient. It also looks at some of the myths that add to the illusions that physicians sometimes project, both to bolster their persona as well as to hide the uncertainty that is behind many of their decisions. The writer is not a physician, which serves to give the book greater credibility, and is illustrated by her own anxiety regarding her daughter's cancer at an unusual age. As a physician, I found myself agreeing with most of her insights. Her analysis of the seating patterns and hierarchy in medical conferences is hilarious and accurate. Although she looked at a department of medicine, I think it holds true for mos specialties.
This book is not an easy read, and it can be fairly slow going because of the academic vocabulary and the sometimes obscure references to philosophy, science and literature. But it is worth reading. If you have been a patient, you may gain insight into your physician's decisions. If you are a physician, you may end up realizing you are not who you thought you were.
 Mystery remains veiled January 8, 2008
0 out of 2 found this review helpful
After reading with disappointment Dr. Groopman's identically titled work, I wanted Dr. Montgomery's account to work, to ring true. Alas it does not. It would be more accurately titled "How Medical School Faulty Say They Think about Medicine, as Recounted to an English Literature Critic."
Dr. Montgomery has no experience working in clinical medicine. So far as her book shows, she has been unable to make effective, sustained contact with anyone who does. That is the fundamental limitation of the book.
In her early chapters, Dr. Montgomery is cramped to say what the practice of medicine IS. If serious about her topic, she should have dumped this antiquarian prejudice and concentrated on what medical practitioners DO.
The book will be a difficult read for anyone who does not share Dr. Montgomery's acquaintance with classical and modern literature. For those who share it, the book may be great entertainment, but they really ought not to congratulate themselves. Understanding Pliny, Hume or Pound, one will not understand very much the day-in, day-out practice of medicine.
An extraordinary book, and right on time July 30, 2007
3 out of 4 found this review helpful
There are two books with this same title, "How Doctors Think," that have arrived at more or less the same time. Dr Groopman's book will sell more copies, and is a useful book for building competence for managing both sides of the doctor-patient interaction. This book is something different. It is a historic milestone that offers extraordinary help to those who are committed to guiding the medical professions in shifting their orientations and competences for the challenges facing them. It arrives at the right moment, in that to effectively address these challenges will require new understandings of what doctors are and do, how they become what they are and how they are trained to do what they do. I am grateful that Ms. Montgomery has published it.
Fantastic and challenging July 9, 2007
2 out of 3 found this review helpful
This is a fantastic book -- it is much more advanced than Groopman's book, and is probably aimed at a different audience. Groopman addresses the layperson, while Montogomery addresses issues and ideas that the average reader would have trouble with. She is a great writer, though, and this is well worth your time.
Brilliant January 18, 2007
18 out of 21 found this review helpful
I was thrilled when I first began reading How Doctors Think, and my feelings did not change when I finally finished the last page of the book. In honest,lyrical prose, Kathryn Montgomery eloquently articulates the complicated tapestry of the clinical decision-making process physicians often encounter in the face of clinical uncertainties and probabilistic medicine. Kudos to a beautifully structured deconstruction of the culture of medicine and medical training! I highly recommend this book to those involved in medical education curricular development. For those who are already medical students, residents, fellows, and attending physicians, I would suggest this as a must-read book on your reading list.
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