Dr. Leana Wen

emergency physician, public health leader, patient advocate

When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests

January 2013, St. Martin’s Press

In the vein of Atul Gawande’s
The Checklist Manifesto comes When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests, a provocative, far-reaching prescription for reform in the way Americans approach and receive medical care.

Written by two Harvard E.R. physicians,
When Doctors Don’t Listen argues that diagnosis, once the cornerstone of medicine, is fast becoming a lost art, with grave consequences. Replacing the traditional diagnostic method, centered on the taking of patient histories, is “cookbook medicine,” in which patients are understood in terms of their “chief complaint” and physicians rely on well-mapped decision pathways, that, though adopted with good intentions, end up stripping medicine of its efficacy and humanity. As anyone who has recently visited an E.R. can attest, submitting to the bewildering battery of tests required for various “work-ups” and “rule-outs” is a poor substitute for understanding what’s wrong. Patients and doctors alike have become trapped in an increasingly dysfunctional system.

When Doctors Don’t Listen combines medical narrative and trenchant analysis with concrete steps for getting the best possible care. In straightforward, engaging language, Doctors Wen and Kosowsky give voice to what a growing number of healthcare workers have come to believe: that the way medicine is taught and practiced is in urgent need of change, and that now is the time to address it. Theirs is not, however, a top-down approach; instead, it requires patients to take the lead to usher in a new era that will not only improve individual medical care, but also lead the way to meaningful healthcare reform.