Physicians Aren't Giving Patients the Whole Story

Joe Cantlupe, for HealthLeaders Media , October 14, 2010

The doctor takes off his glasses, moves his swivel seat behind his desk takes out his prescription pad and writes what medication the patient should receive. He says what should be done, and what is necessary, to help the patient feel better.

Unfortunately, most of the conversations don't go enough into the depth of procedure for the disease or illness involved, leaving many patients unprepared to make fully informed decisions about their care, University of Michigan researchers concluded in a national study and survey about medical decisions. The study was funded by the Foundation for Informed Medical Decision Making.

Too often, physicians are leaving patients  "in the dark" and do not include enough information about sensitive medical decisions such as screening tests for colorectal or breast cancer, the need for prescription medications for hypertension, and issues related to hip replacement, cataracts, and lower back pain, the researchers say. For instance only 20% of patients considering breast cancer screening reported hearing anything about the "cons" of such screening, while 50% reported hearing mostly about the "pros," according to the study.

Generally, the study found that most patients hear far more from doctors about advantages than the disadvantages of medications, the study says. Patients also do not understand essential facts about common medical decisions, or are mostly offered opinions, without their own preference attached.

So it goes:  another study that examines communication issues involving patient and physician, in which seemingly little "tweaks" in the system—improving the one-on-one dialogue, possibly adding more time to the process—could eventually mean a big difference in healthcare.

Variations of the communication theme continually crop up in making the physician-patient experience better.  Recently, I reported from a separate University of Michigan study that physicians lacked the confidence to be totally up front with patients about certain issues, such as the need for weight loss, for instance.

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3 comments on "Physicians Aren't Giving Patients the Whole Story"

Garry Goe, MD, FACEP (11/10/2010 at 10:45 PM)
The article seems to blame physicians as the problem for pooly informed decision-making. The reality is the economic pressures of the system and poor health literacy won't allow for the level of education supported by the FIDM. Patients pay for my professional opinion and must trust in my advocacy to support their values. If I have to educate every patient about every facet of their care, I'd see three patients a day. Medical care is too complex. Knowing our patients as best as we can, we have to navigate the course and make recommendations to them, sifting out options based on our education and training. I am not wiki-physician. I'm not paternalistic either, just realistic.

William Bodnar (10/20/2010 at 1:11 PM)
The issue of patients received clear, understandable information has been with us forever. The issue of patients actually making informed decisions....decisions that weight the risks, benefits, pain, all costs and viable options.....will continue to emerge as baby boomers age and the web removes historic impediments. Greater patient involvement and understanding is one critical need if we are to reduce overall spending in the years ahead.

guitardiva (10/15/2010 at 10:29 AM)
Indeed. Recently, I was handed a prescription for a new medication and when I asked what the known side effects were, I was told "Don't sabotage yourself." What kind of communication is THAT?




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