How Doctors Think: Clinical Judgment and the Practice of Medicine [JAMA book review]

This book review was just published in the May 3 issue of JAMA:
Moore, Donald E. Jr. How Doctors Think: Clinical Judgment and the Practice of Medicine, by Kathryn Montgomery, 246 pp, $39.50, ISBN 0-19-518712-1, New York, NY, Oxford University Press, 2006. [book review]  JAMA 2006; 295:2080-2081.

JAMA extract: Kathryn Montgomery, PhD, has written a thoughtful and provocative book that challenges us to reconceptualize our assumptions about how physicians think in the clinical encounter, how physicians-in-training are taught, and how physicians and patients interact. In the introductory chapter, Montgomery, who is professor of bioethics and medical humanities at Northwestern University, starts by stating that clinical medicine is not a science. Furthermore, she suggests that the widely held and unquestioned assumption that clinical medicine is a science and that it follows the scientific method leads to approaches to medical education that are too harsh and to clinical practice that is too impersonal and, as a result, unsatisfying to physicians and patients. Rather than considering clinical medicine a science, she proposes that it be conceptualized as a rational, science-using practice. She draws on Aristotle’s phronesis*—the flexible interpretive capacity that enables moral reasoners to determine the best action to take when knowledge depends on circumstances—to characterize physician thinking in the clinical encounter as interpretive practice.

Moore concludes: How Doctors Think is a useful book for everyone involved in medicine, from medical educators, who could use it to develop a more humane approach to medical education, to individual practitioners, who could use it to help reflect on and improve their clinical practice. [full text by subscription]
E-mail the reviewer         Journal Record                     BMJ Review   
University of Virginia Podcast: How Doctors Think, with Kathryn Montgomery [scroll down, fourth item from the end]

* From the OED Online: Phronesis: Practical understanding; wisdom, prudence; sound judgement.


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