Does your doctor use intuition?
by Ann Japenga
Re-printed from USA Weekend, Health
An old-time hunch is a good partner for science, say prominent med school teachers.
For the first time, prominent physicians are declaring that intuition — knowledge not based on conscious reasoning or test results — is a legitimate medical tool.
“I’m a rationalist and a scientist,” says Jerome Groopman, M.D., a Harvard Medical School professor and author of Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine. “But there have been many instances when I’ve had a deep sense about a patient that is not informed directly by lab tests. It is a gut sense.”
This gut sense is gaining ground: On Wednesday, the annual meeting of the conservative American Psychiatric Association will hear about intuition from Los Angeles psychiatrist Judith Orloff, author of Dr. Judith Orloff’s Guide to Intuitive Healing.
At UCLA, where she is an assistant professor, Orloff is coaching psychiatry resident Meredith Sagan in intuition-based medicine. Med schools now teach little about intuition, but Orloff and Sagan hope their collaboration will serve as a prototype. “I can’t imagine how I’d practice medicine without intuition,” Sagan says. “This is the direction medicine is heading.”
Some see it veering in the opposite direction. Over the past decade, enthusiasm has grown for “evidence-based” or “outcomes-based” medicine — the use of tests and treatments proven through rigorous research.
Managed-care companies maintain that evidence-based medicine will reduce costs. Yet Harvard’s Groopman says intuition also saves money. Example: A man with bone-marrow failure was being treated with blood transfusions. In an intuitive leap, Groopman determined the patient would benefit from added testosterone (the hormone is vital for production of red blood cells in men). Soon, the man required only a third as many transfusions.
“My intuition saved this patient’s insurance company hundreds of dollars per unit of blood, plus all the hospital and nursing costs that go with transfusions,” says Groopman.
At the University of Virginia, associate professor David Slawson, M.D., teaches that skilled physicians are like skilled musicians. A physician needs to be grounded in science but also must have the ability to improvise. The result, according to Slawson: “Good clinical jazz.”
How to find an intuitive physician
Doctors Judith Orloff and Jerome Groopman say an intuitive doctor will . . .
- Take time to listen. Intuition isn’t magic. It relies in part on a heightened sensitivity to subtle verbal and non-verbal cues expressed in ordinary conversation.
- Encourage second opinions. An intuitive doctor realizes medicine has hidden dimensions and accepts that another doctor may be able to tune into aspects of your case he or she has overlooked.
- Honor your hunches about your well-being, even when they seem irrational. In the most effective collaborations, your doctor will graft his intuition onto yours.
- Keep up with science. Some doctors may rely too much on intuition. Each week, a wealth of new scientific information is available to doctors; yours should take advantage of the latest studies. “Intuition shouldn’t be an excuse for not keeping up,” says Brian Haynes, M.D., editor of the journal Evidence-Based Medicine.