Better Doctors, Better Patients, Better Decisions

by Gigerenzer, Gerd; Gray, J. A. Muir

• ISBN13: 9780262016032
• ISBN10: 0262016036
• Edition: 1st
• Format: Hardcover
• Copyright: 2011-03-25
• Publisher: Mit Pr

Summary

Contrary to popular opinion, one of the main problems in providing uniformly excellent health care is not lack of money but lack of knowledge--on the part of both doctors and patients. The studies in this book show that many doctors and most patients do not understand the available medical evidence. Both patients and doctors are "risk illiterate"--frequently unable to tell the difference between actual risk and relative risk. Doctors often cannot interpret test results; patients cannot make informed decisions if they are given bad information. Surprisingly, treatments vary widely from one region to another. For example, in one referral region in Iowa, sixty percent of prostate patients had surgery, while in another region only fifteen percent had the same surgery. This unwarranted disparity in treatment decisions is the rule rather than the exception in the United States and Europe. All of this contributes to much wasted spending in health care. The contributors to Better Doctors, Better Patients, Better Decisionsinvestigate the roots of the problem, from the emphasis in medical research on technology and blockbuster drugs to the lack of education for both doctors and patients. They call for a new, more enlightened health care, with better medical education, journals that report study outcomes completely and transparently, and patients in control of their personal medical records, not afraid of statistics but able to use them to make informed decisions about their treatments.

Table of Contents

The Ernst Strüngmann Forum	p. vii
List of Contributors	p. ix
Health Literacy: Is the Patient the Problem?
Launching the Century of the Patient	p. 3
When Misinformed Patients Try to Make Informed Health Decisions	p. 29
Reducing Unwarranted Variation in Clinical Practice by Supporting Clinicians and Patients in Decision Making	p. 45
Do Patients Want Shared Decision Making and How Is This Measured?	p. 53
Health Illiteracy: Roots in Research
Health Research Agendas and Funding	p. 61
Reporting of Research: Are We in for Better Health Care by 2020?	p. 83
Medical Journals Can Be Less Biased	p. 103
What Is Needed for Better Health Care: Better Systems, Better Patients or Both?	p. 117
Health Illiteracy: Spread to the Public
Statistical Illiteracy in Doctors	p. 137
Statistical Illiteracy in Journalism: Are Its Days Numbered?	p. 153
Improving Health Care Journalism	p. 169
Barriers to Health Information and Building Solutions	p. 191
Health Care 2020
How Can Better Evidence Be Delivered?	p. 215
The Drug Facts Box: Making Informed Decisions about Prescription Drugs Possible	p. 233
Reengineering Medical Education	p. 243
The Chasm between Evidence and Practice: Extent, Causes, and Remedies	p. 265
The Future of Diagnostics: From Optimizing to Satisficing	p. 281
Direct-to-Consumer Advertising: Status Quo and Suggestions to Enhance the Delivery of Independent Medication Information	p. 295
How Will Health Care Professionals and Patients Work Together in 2020? A Manifesto for Change	p. 317
Abbreviations	p. 339
Glossary	p. 343
Bibliography	p. 347
Subject Index	p. 387
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