Academic journal article Australian Health Review

Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020

Academic journal article Australian Health Review

Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020

Article excerpt

BETTER DOCTORS, BETTER PATIENTS, BETTER DECISIONS: ENVISIONING HEALTH CARE 2020 G. Gigerenzer and J. A. M. Gray The MIT Press, 2011. ISBN 978-0-262-01603-2.

This book is a treasure trove of information about why the health system is not working well. It is not so strong on practical ways to changeit,despitewell-qualifiedauthorsandinterspersed chapters recounting group discussions. The book is the proceedings of a 2009 conference, reporting both the papers and a synthesis (not a consensus) of the debates at the conference.

The book starts boldly: 'Patients appear to be the problem in modern high-tech health care: they are uninformed, anxious, noncompliant folk with unhealthy lifestyles'. This chapter, as well as introducing the book, introduces the first of four parts, on health literacy (which includes chapters on shared decision making and reducing unwarranted variation). The second and third parts are about health illiteracy, discussing problems of reporting of research and statistical illiteracy. Chapters in these sections report depressing research about the extent of statistical illiteracy among clinicians, with the consequence that many (most?) clinicians are not qualified to advise patients of risks of particular pathways and odds of particular outcomes. Numerous policy (and research) suggestions are made in the round table discussions in these two parts, but some are bold without clarity of implementation pathways (or even agents to lead implementation), some are tried and true (teach medical students better) and some simply reiterate the problem. …

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