Of first importance

July 26, 2019
Diasome.comDiasome BlogOf first importance
James H. Gilmore
Jim Gilmore, co-founder of Strategic Horizons LLP, is co-author of The Experience Economy and Authenticity: What Consumers Really Want, co-editor of Markets of One, and most recently author of Look: A Practical Guide for Improving Your Observational Skills. He is an assistant professor in the Innovation and Design department in the Weatherhead School of Management at Case Western Reserve University, a Batten Fellow at the Darden School of Business at the University of Virginia, and a Visiting Lecturer in Apologetics at Westminster Seminary California.
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Any person with Type-1 diabetes, and any supporting family member of friend, can readily find an overwhelming amount of information about various treatment and technology options associated with insulin therapy. Visit a JDRF event and one encounters dozens of exhibit booths showcasing various pens, pumps, injectors, inhalers, sensors, monitors, and other delivery aids. Or hop online and get hit by an avalanche of sites vying for clicks. (My recent search on “insulin options” netted over 50 million hits and a search on “Type-1 diabetes options” had over 250 million!) Most of this information focuses on diabetes, insulin, or methods of delivery of insulin. Notably absent from this variety of intelligence—all purportedly aimed at helping make treatment decisions—is much to help understand that which is of first importance: You.

Doctors Jerome Groopman and Pamela Hartzband’s coauthored book, Your Medical Mind: How to Decide What is Right for You (2011) provides an invaluable resource for helping make wise medical choices. The two physicians explain how a richer awareness of and appreciation for one’s own mental preferences and biases—usually shaped by family attitudes, values, and prior experiences with others facing similar circumstances—can greatly aid with navigating complex information when making critical decisions. I recommend the book whenever I have an opportunity to speak or consult with any health care organization.

Groopman and Hartzband crisply and insightfully “examine the powerful and often hidden influences outside and inside the patient’s mind that can sway thinking and distort judgment” (p. 8), including (are you ready for this?): the framing of numbers in either positive or negative terms, how the presentation of facts in different ways can alter the perception of risks and benefits, the paternalistic approach often prevalent when doctors deal with patients, the difference between general guidelines for aggregated groups and specific advice for unique individuals, how the sharing of details about various treatments can significantly alter decision-making, and the role of factors such as the regret of past actions, “neighborly advice,” coping mechanisms, and other personal medical histories.

Groopman and Hartzband examine the powerful and often hidden influences outside and inside the patient’s mind that can sway thinking and distort judgment

One of the most insightful chapters in the book addresses how the consideration of patient attitudes is often overlooked, and when properly understood can greatly help individuals “understand what makes sense for them.” (p.47) Groopman and Hartzband begin by sharing their own respective narratives in dealing with various ailments and diseases in their own lives, then assess stories conveyed to them by hundreds of others, and conclude with identifying two main mind-set considerations: Whether one is a Maximalist or Minimalist in the amount of desired level of treatment, and whether one tends to be Believer or Doubter about prescribed advice and newly emerging technologies.

I’ve taken these two dimensions and created a simple 2x2 matrix which portrays the mental states described by Groopman and Hartzband. Examine it below, and ask yourself: Which quadrant best represents my medical mind? Most importantly, do read the book. It may be the best step you ever take to better understand what’s right for you.

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Diasome seeks to serve people with diabetes by developing cutting-edge therapies and by serving as a forum for our community to educate and inform others about the challenges and successes in living with diabetes. We actively seek perspectives from the rich and diverse world of clinicians, scientists, thought leaders and people with diabetes. To share your unique perspective with us, email Diasome at info@diasome.com

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