Dr. Jerome Groopman says when it comes to making medical decisions, he is a “maximalist,” a “technologist” and a “believer.” These qualities color his own choices and advice to patients, and he says they emerged directly from his Jewish upbringing.

We all have a medical mindset, Groopman argues, and it can be easily pinned down and translated for more effective communication in health care. It accompanies us from early childhood through the end of life, whether we are in the role of patient, physician or caregiver. The Harvard University oncologist and author discussed his own mindset and how we can determine ours at the Association of Health Care Journalists Conference this week in Boston, MA.

Culture and upbringing are perhaps the greatest shapers of a medical mindset. Groopman is the son of eastern European immigrants who put physicians “on a pedestal,” he says, and any natural medical intervention apart from the latest technology was viewed “as a throwback to village life.” His oncological training at the advent of bone marrow transplantation reinforced his faith in intense intervention.

When medical decisions must be made, Groopman advises patients to evaluate both their own mindset and that of their doctor. Having the vocabulary to describe mindsets is crucial, and Groopman suggests that anyone involved in such decisions should consider assigning oneself with the following labels. (Select one word from the following three pairs). 

1) Maximalist- “A maximalist is someone ahead of the curve,” Groopman says. They typically favor medication as a first-resort, whether or not there is a proven benefit. Maximalists often choose surgical intervention,aggressive chemotherapy and intensive care.

Minimalist- “A minimalist is someone for whom less is more,” Groopman says. Minimalists do not jump at the chance to take medication, and are far more likely to hold off on any invasive medical intervention. They often believe in “waiting it out.”

2) Believers- “Believers are certain there is a good solution to their problem,” Groopman says. Believers have faith that when they take a pill, they are on their way to better heath. They are generally trusting of physicians and the medical system.

Doubters- Doubters often worry that any treatment may be worse than the disease itself. They delay medication and therapy until absolutely necessary.

3) Technologists- With such a mindset comes a faith in prescription drugs, invasive
therapies and hospital stays.

Naturalists- Naturalists would rather take a vitamin or herbal supplement than any
drug.

Groopman says patients are able to better communicate with their physicians and better assess their end of life preferences if they identify their mindsets. Surrogates are better able to act on behalf of patients if medical mindsets are considered and discussed.

Pamela Hartzband, M.D., Groopman’s wife and an assistant professor and attending physician in the Division of Endocrinology at Beth Israel Deaconess Medical Center, says she agrees with her husband on the importance of evaluating one’s medical mindset. Hartzband and Groopman received similar medical educations, are on staff at the same medical institution, and are married, but her mindset still differs from his.

Hartzband says she is a “minimalist” and a “doubter,” and she hopes to help implement training on medical mindsets in medical schools, as mindsets are often set by young adulthood. The language Groopman outlined has proven beneficial to her as both a patient and a physician. “The language has helped us in our own clinical interactions, and when used, patients have expounded on it,” Hartzband says.

-Randi Belisomo

Learn more from the Life Matters Media Newswire:

Bed sores: New technology decreases occurrence

An OP-ED for PBS: Inequalities in the health care system

Texas bill would clarify end-of-life treatments