Understanding medical mindsets

How two Harvard docs make the 'best medical choices'

Topics: Physician Issues, Communication Skills, Skill Development, Workforce

November 2, 2011

In a Time interview last week, Harvard University physicians Jerome Groopman and Pamela Hartzband outlined "medical mindsets" that determine physicians' and patients' treatment approaches.  

The married couple recently published Your Medical Mind: How to Decide What Is Right for You, a book outlining how personal values and history influence medical decision making. In the book, Groopman and Hartzband explain how understanding one's medical mindset can lead to making smart decisions, Time reports.

Types of medical mindsets

Groopman and Hartzband separate medical mindsets into a handful of distinct categories.

First, they say each physician is either a minimalist or a maximalist. Minimalists generally opt to do the least possible to treat a medical problem, while maximalists will attempt to "be ahead of the curve" and do anything possible to address the problem.

Second, each physician tends to be a believer or a doubter. Believers tend to think medicine will provide a good solution for any given health problem, while doubters are more concerned with possible side effects or unintended consequences.

How backgrounds influence medical mindsets

According to Groopman and Hartzband, each person's medical mindset is determined by lifestyle, personal history, and values. For example, Groopman was raised in a household that respected physicians and dismissed natural healing and folklore. After his father died from a myocardial infarction, he turned to medicine as a way to save lives. As a result, he considers himself a believer and maximalist.

Meanwhile, Hartzband's mother was "an artist and freethinker" who was quick to dismiss experts and physicians. At 80 years old, both of Hartzband's parents are in excellent health. "If you believe you have generally good health, you don't want to do anything that might make matters worse," Hartzband says. According to her, these experiences caused her to become a doubter and minimalist.

Empowering patients to make personal medical decisions

Discussing treatment options in terms of medical mindsets can help empower patients to make smart medical choices, according to Groopman and Hartzband. Experts often disagree on treatment options because of differing medical mindsets, and patients should understand how those mindsets could influence their decisions, the pair says (Szalavitz, Time, 10/28).

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