Saturday, November 24, 2007

Thinking about thinking in medicine


















Thinking about thinking in medicine fascinates me. Physicians constantly make decisions under uncertainty, faced with incomplete and imperfect information. Analyzing decision making in medicine provides a rich texture for examining the humble limits of being human.

As an aspiring physician and leader in healthcare, I recognize the importance of self-awareness and a commitment to improving my ability to think. Physicians are thinkers - constantly solution searching and trying to figure out how to maintain and improve people's health - so I hope that this blog can provide a platform for discussing thinking in medicine.

Up front, I want to pay credit to two essayists who have inspired my blog:

Dr. Nassim Taleb, author of The Black Swan (fooledbyrandomness.com)

Dr. Jerome Groopman, author of How Doctors Think (jeromegroopman.com)

As a final note, this blog is not about thinking about thinking about thinking in medicine; instead, it is a practical attempt to deal with the complexities and realities involved with making decisions in healthcare.

To that end, I hope to act as a healthcare epistemocrat. But what is an epistemocrat? In his marvelous book, The Black Swan, Taleb defines an epistemocrat as "someone of epistemic humility, who holds his own knowledge in greatest suspicion." For Dr. Groopman, this person continues to search for answers by asking, "What else could it be?" Epoche, a Greek word that translates as "suspending judgment," lies at the heart of an epistemocrat's quest - a quest that began many years ago in medicine by empirical skeptics like Sextus Empiricus and Aenesidemus (founder of pyrrhonism).

This perspective confronts a critical paradox in medicine: searching versus acting. Considering how to balance this paradox is important to understanding and improving decision making in medicine.

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