“Revolutions are often fought over dichotomies—the king versus the people, the bourgeoisie versus the proletariat, and, of course, the autonomous patient versus the paternalistic doctor.” So observes Peter Ubel in the conclusion of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together.
Who decides? Doctor or patient? For decades, too many of the advocates who have tangled with the establishment to empower patients have acted as though there is only black and white. The patient decides, not the doctor. The result has been a toxic standoff.
By throwing the dichotomy under the bus, Ubel takes a crucial step forward. Patients and doctors must work together to get to the right decision. The much tougher questions follow: How? What are the rules of engagement? How should the interaction proceed? Who does what?
Ubel’s expert dissection of the hidden complexities of these questions is thorough and impressive. In addition, Ubel is quite evidently a gifted writer,thinker, and communicator. Critical Decisions is a first-rate effort to popularize the science of medical decision making. Some readers will devour this book;in fact, researchers in the medical decision-making community might finish itin a single sitting. And general readers with an intellectual interest in healthcare—those who eagerly anticipate Atul Gawande’s next New Yorker article…(Read more at Health Affairs)