Winner of a HIGHLY COMMENDED AWARD in the Surgery category of the 2011 BMA Medical Book Competition. A vital question that concerns many: how to make surgery safer? Is it by tightening the regulations and imposing rigid protocols or by empowering surgeons with the resources to help them make safer decisions? This is the book for those who would choose the second option. What do you think separates smart surgeons from the rest? Why, on the other hand, do surgeons make blunders despite having experience and knowledge? There is only one answer to both questions - it is decision-making. Decision-making is an art and is at the heart of surgery. It decides between excellent and poor surgical performance. Although a vital part of professional activity, surgeons are not generally aware of how to optimize decision-making skills. Making a good decision is a skill that, like any skill, needs to be developed and this book reveals how surgeons can sharpen these skills. Presented here are the findings from decision science that surgeons, irrespective of specialty or seniority, can apply to everyday practice. Surgeons are required to adapt new strategies throughout their careers. Ideas taken from this book will help to speed up the learning curve. It offers answers to the questions which experienced surgeons may find difficult to explain. Equally, it answers the questions that trainees may even find difficult to ask. You are expected to be cognizant of the knowledge behind making decisions. Nonetheless, no-one tells you how to access this information easily. This book is the key to that vital information. "This is a very helpful book, written in a friendly and accessible style. It provides many fascinating examples of the phenomenon which so interests us surgeons. Surgeons of all ages and specialties will find it helpful to know about themselves and how they are challenged." Mr Tony Giddings, Past President of the Association of Surgeons of GB & Ireland

This volume presents novel concepts to help physicians and health care providers better understand the thought processes and approaches used in clinical decision-making and how we develop those skills as we transition from being a medical student to post-graduate trainee to independent practitioner. Approaches presented range from simple rules of thumb, pattern recognition, and heuristics, to more formulaic methods such as standard operating procedures, checklists, evidence-based medicine, mathematical modeling, and statistics. Ways to recognize and manage errors and how our decision-making can be improved, are also discussed. An Introduction to Medical Decision-Making presents several innovative techniques to allow the reader to use the principles presented and integrate the ethical, humanistic and social aspects of decision-making with the pragmatic and knowledge-based aspects of clinical medicine. It also highlights how our thinking processes, emotions, and biases affect decision-making. This invaluable resource will allow students and physicians to evaluate and critically discuss their decisions objectively to become more efficient and effective, and maximize the quality of care they provide.

Surgeons start their career in the expectation that it will bring personal satisfaction through an unparalleled sense of achievement and professional growth. Nonetheless, a career in surgery carries with it serious challenges: surgical training is rigorous, both emotionally and physically, and demands that the surgeon adjust to unpredictability. Chronic levels of stress can affect surgical performance, the quality of family relationships, and even the nature of the doctor–patient relationship. Unmanaged stress has been shown to contribute to physical illness, emotional problems, absenteeism, poor job performance, drug abuse, and negative social attitudes. With a background in both surgery and psychological medicine, Dr Shiralkar examines the psychosocial burden of being a surgeon and offers insights into the role of intra-human factors in surgery. He reveals surgical performance from a psychological perspective and highlights the factors that cause unsatisfactory performance. He also offers solutions to rectify the problem and prevent burnout. The book will be invaluable to all those embarking on a surgical career, as well as to established surgeons in all specialties who wish to understand how to identify and manage the factors that could lead to career-limiting levels of stress.

Being a good clinician is not just about knowledge – how doctors and other healthcare professionals think, reason and make decisions is arguably their most critical skill. While medical schools and postgraduate training programmes teach and assess the knowledge and skills required to practice as a doctor, few offer comprehensive training in clinical reasoning or decision making. This is important because studies suggest that diagnostic error is common and results in significant harm to patients – and errors in reasoning account for the majority of diagnostic errors. The ABC of Clinical Reasoning covers core elements of the thinking and decision making associated with clinical practice – from what clinical reasoning is, what it involves and how to teach it. Informed by the latest advances in cognitive psychology, education and studies of expertise, the ABC covers: Evidence-based history and examination Use and interpretation of diagnostic tests How doctors think – models of clinical reasoning Cognitive and affective biases Metacognition and cognitive de-biasing strategies Patient-centred evidence based medicine Teaching clinical reasoning From an international team of authors, the ABC of Clinical Reasoning is essential reading for all students, medical professionals and other clinicians involved in diagnosis, in order to improve their decision-making skills and provide better patient care.

Despite diagnosis being the key feature of a physician's clinical performance, this is the first book that deals specifically with the topic. In recent years, however, considerable interest has been shown in this area and significant developments have occurred in two main areas: a) an awareness and increasing understanding of the critical role of clinical decision making in the process of diagnosis, and of the multiple factors that impact it, and b) a similar appreciation of the role of the healthcare system in supporting clinicians in their efforts to make accurate diagnoses. Although medicine has seen major gains in knowledge and technology over the last few decades, there is a consensus that the diagnostic failure rate remains in the order of 10-15%. This book provides an overview of the major issues in this area, in particular focusing on where the diagnostic process fails, and where improvements might be made.

This book focuses on surgical decision-making, a key topic for both surgeons and emergency physicians who are faced with patients with acute abdominal pain. Providing easy-to-understand technical details and discussing the interpretation of normal and pathological images, it is a valuable resource for surgeons and emergency physicians who are not used to applying clinical US in this field, enabling them to shorten the diagnostic path and avoid unnecessary costs and exposure to radiation. It is also a practical reference guide for surgeons and doctors wanting to apply US as a decision-making tool in the context of acute abdominal pain.

Named one of Vulture’s Top 10 Best Books of 2020! Leftist firebrand Fredrik deBoer exposes the lie at the heart of our educational system and demands top-to-bottom reform. Everyone agrees that education is the key to creating a more just and equal world, and that our schools are broken and failing. Proposed reforms variously target incompetent teachers, corrupt union practices, or outdated curricula, but no one acknowledges a scientifically-proven fact that we all understand intuitively: Academic potential varies between individuals, and cannot be dramatically improved. In The Cult of Smart, educator and outspoken leftist Fredrik deBoer exposes this omission as the central flaw of our entire society, which has created and perpetuated an unjust class structure based on intellectual ability. Since cognitive talent varies from person to person, our education system can never create equal opportunity for all. Instead, it teaches our children that hierarchy and competition are natural, and that human value should be based on intelligence. These ideas are counter to everything that the left believes, but until they acknowledge the existence of individual cognitive differences, progressives remain complicit in keeping the status quo in place. This passionate, voice-driven manifesto demands that we embrace a new goal for education: equality of outcomes. We must create a world that has a place for everyone, not just the academically talented. But we’ll never achieve this dream until the Cult of Smart is destroyed.

"Yes" or "No," from the #1 New York Times bestselling author Spencer Johnson, presents a brilliant and practical system anyone can use to make better decisions, soon and often -- both at work and in personal life. The "Yes" or "No" System lets us: focus on real needs, versus mere wants create better options see the likely consequences of choices and identify and then use our own integrity, intuition, and insight to gain peace of mind, self-confidence, and freedom from fear

For readers of Henry Marsh's Do No Harm, Paul A. Ruggieri's Confessions of a Surgeon, and Atul Gawande's Better, a pioneering surgeon shares memories from a life in one of surgery’s most demanding fields The 1980s marked a revolution in the field of organ transplants, and Bud Shaw, M.D., who studied under Tom Starzl in Pittsburgh, was on the front lines. Now retired from active practice, Dr. Shaw relays gripping moments of anguish and elation, frustration and reward, despair and hope in his struggle to save patients. He reveals harshly intimate moments of his medical career: telling a patient's husband that his wife has died during surgery; struggling to complete a twenty-hour operation as mental and physical exhaustion inch closer and closer; and flying to retrieve a donor organ while the patient waits in the operating room. Within these more emotionally charged vignettes are quieter ones, too, like growing up in rural Ohio, and being awakened late at night by footsteps in the hall as his father, also a surgeon, slipped out of the house to attend to a patient in the ER. In the tradition of Mary Roach, Jerome Groopman, Eric Topol, and Atul Gawande, Last Night in the OR is an exhilarating, fast-paced, and beautifully written memoir, one that will captivate readers with its courage, intimacy, and honesty.

Katrina Firlik is a neurosurgeon, one of only two hundred or so women among the alpha males who dominate this high-pressure, high-prestige medical specialty. She is also a superbly gifted writer–witty, insightful, at once deeply humane and refreshingly wry. In Another Day in the Frontal Lobe, Dr. Firlik draws on this rare combination to create a neurosurgeon’s Kitchen Confidential–a unique insider’s memoir of a fascinating profession. Neurosurgeons are renowned for their big egos and aggressive self-confidence, and Dr. Firlik confirms that timidity is indeed rare in the field. “They’re the kids who never lost at musical chairs,” she writes. A brain surgeon is not only a highly trained scientist and clinician but also a mechanic who of necessity develops an intimate, hands-on familiarity with the gray matter inside our skulls. It’s the balance between cutting-edge medical technology and manual dexterity, between instinct and expertise, that Firlik finds so appealing–and so difficult to master. Firlik recounts how her background as a surgeon’s daughter with a strong stomach and a keen interest in the brain led her to this rarefied specialty, and she describes her challenging, atypical trek from medical student to fully qualified surgeon. Among Firlik’s more memorable cases: a young roofer who walked into the hospital with a three-inch-long barbed nail driven into his forehead, the result of an accident with his partner’s nail gun, and a sweet little seven-year-old boy whose untreated earache had become a raging, potentially fatal infection of the brain lining. From OR theatrics to thorny ethical questions, from the surprisingly primitive tools in a neurosurgeon’s kit to glimpses of future techniques like the “brain lift,” Firlik cracks open medicine’s most prestigious and secretive specialty. Candid, smart, clear-eyed, and unfailingly engaging, Another Day in the Frontal Lobe is a mesmerizing behind-the-scenes glimpse into a world of incredible competition and incalculable rewards.