Early study found it had high accuracy, but experts say it won't replace colonoscopy anytime soon
FRIDAY, Nov. 9 (HealthDay News) -- Doctors often ignore or misunderstand what patients want in terms of treatment, and this "preference misdiagnosis" can be harmful to patients, experts say.
The authors of a new report say a doctor cannot recommend the right treatment without fully understanding a patient's preferences, yet evidence suggests there are often large gaps between what patients want and what doctors think they want.
For example, one study found that doctors believed that 71 percent of breast cancer patients rated keeping their breast as a top priority, but the actual number was just 7 percent, said Albert Mulley from the Dartmouth Center for Health Care Delivery Science in Hanover, N.H., and colleagues.
Another study found that patients with dementia placed much less value than doctors on staying alive with severely declining mental function. And a third study found that patients may change their treatment preference when informed about its risks and benefits. For example, 40 percent fewer men preferred surgery for benign prostate disease after they learned about the risks of sexual dysfunction.
Ensuring that treatment matches a patient's preferences is not as simple as asking what a patient wants, but requires three specific steps, said the authors of the article, published online Nov. 8 in the BMJ.
The three steps are: a mindset of scientific detachment; the use of data to arrive at a provisional diagnosis; and including the patient in three phases of decision making -- team, option and decision talk.
Along with being the ethical thing for doctors to do, fully understanding patients' preferences may also help reduce health-care costs, the researchers said. They noted that studies show that engaged and informed patients often choose to have less-intensive care and are more careful about having lots of procedures.
"It is tantalizing to consider that budget-challenged health systems around the world could simultaneously give patients what they want and cut costs," the researchers concluded in a journal news release.
The American Academy of Family Physicians offers tips for talking with your doctor.
SOURCE: BMJ, news release, Nov. 8, 2012
Copyright © 2012 HealthDay. All rights reserved.
Thu Nov 15, 2012 03:43 PM
Doctors have maintained an offensively, patronizing posture towards patients treating us as mindless ignoramouses throughout the process of making medical decisions for us, failing to provide thorough and competent information about treatment options and the hazards of recommended treatment including but not limited to natural alternatives. In doing so the medical profession has not only cost this country trillions of dollars in increased health care costs for seniors and disabled citizens but has also destroyed the lives of many, causing them to be burdened with additional iatrogenic disorders that could have easily been averted as these were caused by the harmful RX drugs prescribed without giving patients full information about alternatives. Additionally, Obama-Care, while well intended has not provided our citizens with the choice of what kind of health care they want, ie. natural or traditional and is creating serious economic dis-incentives to opting for natural health care. When a Senior Citizen on a fixed income is given the choice of taking harmful and potentially addicitive pain medicines such as Vicoden or alternatively using less harmful over the counter medicines such as tylenol or homeopathic medicines that would reduce their pain or elimininate it entirely, most on fixed income will opt for the free but harmful RX drug, simply because of the economic dis-incentive to use less harmful alternatives.
It must become a priority of the AMA and the Obama Administration to eliminate such economic dis-incentives and to require all doctors to provide every patient with every conceivalbe alternative and proper and adequate, un-biased infomration, so as to allow patients the opportunity to make an informed decision about their health care.
Ulness all of us demand these choices, we will be denied them.
Treatment of cancer with devestating surgery or chemotherapy drugs without first informing patients --in an unbiased and respectful manner-- of all available alternatives, should be punishible as a crime against humanity and made an offense that would cost medical professionals prison time. Perhaps then they would take patients right to chose, seriously.
Thu Nov 15, 2012 07:06 PM
Yikes. Clearly you saw the wrong doctors. I've had two separate cancers. None of the professionals I've dealt with have been the least bit patronizing or pushy. The downsides of all treatments were clearly explained, and the doctors pointed me to other sources of information and left final decisions to me. Both doctors did mention other patients' success with natural remedies to manage side effects. Doctors cannot, however, recommend 'alternatives' because no objective data on their safety and efficacy exist. The pharma industry sure isn't perfect, but at least some regulatory oversight is in place, and if you want to know all about the drug, read the package insert and search on PubMed. As for your final suggestion--what? We're going to send physicians to jail for failing to recommend a pilgrimage to Lourdes or coffee enemas?
Wed Nov 21, 2012 07:07 PM
Sat Nov 24, 2012 11:53 PM
Replying to anonf:
I don't think we should be critical or put people down who want to have a choice in healing our own bodies. There are many individuals who prefer natural alternative ways of healing, and there are many like you who swear by the traditional scientific medicines. I, for one think that we can benefit from both alternative and traditional, and we should be able to have that choice. We're individuals and healing comes to different people through different methods. There's no one medicine that's going to be a cure-all for everyone. One medicine may heal you right up but another person may not benefit at all; that individual should be able to try an alternative healing method if he chooses, and the insurance should cover it. I have used water a lot both internally and externally sometimes hot and sometimes cold to relieve discomfort, that's a natural remedy and I have excellent results. Also, I use herbal teas that have brought me much relief from various discomforts. I see a doctor who specializes in natural alternatives and he has helped me a lot. I have to pay out of pocket because it's not covered by insurance. I had to go on prednisone eight years ago to prevent blindness and I developed osteoporosis in my back and lower arms and one hip. I was prescribed fosamax which causes necrosis of the bone in some people; I found it hard to find a dentist who will work on my teeth and there's NO guarantees if the jaw bone will heal if I have to have an extraction. Before taking the predinisone I was strong and healthy. After I went on it, I took different types of calcium and each time my tests showed it was worse. The doctor who specializes in natural alternatives gave me a list of foods that are rich in calcium and I have been eating spinach almost everyday since and my bone density scans have improved! It would have been nice for me if I had been told this and given a choice in the beginning. The same medicine (prednisone) also can induce diabetes. I am now borderline. The same doctor told me to eliminate sugar from my diet and told me of other sweeteners I can use. There is room for both natural alternative and traditional medicine and I believe we should have that choice.
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