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Physicians Aren't Giving Patients the Whole Story

Joe Cantlupe, for HealthLeaders Media, October 14, 2010

It may seem like a blur for the patient as well as the physician, once it is over, but the impact of even the most routine patient visit to the doctor is a time to glean the importance of what it means, and communication often lags—because crucial information is not imparted to the patient, notes Jack Fowler, PhD, senior scientific advisor for the Foundation for Informed Decision-Making and a co-author of the study.

For instance, in discussions about prescription or medication needs, the "patient could be talking with the doctor about a drug they may have for the rest of their life." They should know "what they are getting into, and what's actually involved." Often, those discussions touch on what the patient is dealing with—but not enough, he says.

A patient truly understanding what is happening in communication with his or her doctor "makes for better medicine," Fowler says. Too often, patients "don't' feel involved in the decision making."

The study also indicates what is needed for healthcare reform and the shared decision-making that involves—or should involve—dialogue between informed patients and their providers, according to Fowler and other Michigan researchers.

As Fowler sees it, the study underscores the provisions in the new health reform law that are designed to improve the dialogue between patient and doctors by promoting "shared decision making" and the use of patient decision aids. Ideally, patients are fully informed about the risks and benefits of every option when making a medical decision and their doctor knows which option they prefer.

"The study clearly demonstrates that people routinely make poorly informed medical decisions, informed consent isn't real if patients understand so little about the tests and treatments they are getting," said Michael Barry, MD, professor of medicine at Harvard Medical School and president of the Foundation for Informed Medical Decision Making in a statement.

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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?