Graphic Depiction of a Common Doctors Dilemma
Everyday the graphic representation above is *playing out* in various ways— in many healthcare providers offices across the globe.
- How much information do you share with the patient…?
- How do we give the patient enough *correct* or *pertinent* information without exceeding their capacity to absorb it?
- How much is too much?
- Is there such as thing as too much information?
- many will say “yes”
- many will say “no”
- Some patients want to know *everything*
- Some patients want to know “nothing”
What the risk for “analysis paralysis”?
I firmly believe that patients should be utilizing many available tools… both social media based as well as academically oriented platforms… to improve their understanding of their *disease* or condition, and to understand the options available. Unfortunately, many patients do not want to assume this responsibility, nor are they looking for much information from me. This may seem bizarre to the Particpatory Medicine, or patient centric savvy patient or provider, but it is what it is.
How much info is too much info… who decides how much is too much and when do some patients receive so much information that they reach the end of the curve and suffer from analysis paralysis???
Interesting subject matter
Very thoughtful. You’ve framed this from the doctor POV, and I give you a lot of credit for getting this far. …but that’s at most 1/2 way “there”. The answer to providing the “optimal” amount of info must START from the patient POV…and as you note the answer will vary from patient to patient.Over time, I hope doctors will look at the task of defining “optimal” info for an individual patient as practicinig good science, not guesswork on their part.
Vince… thank you for your thoughtful comment. You are absolutely correct. Unfortunately this is not how most physicians are *taught* to communicate with patients. You may enjoy this post as well… much along the same lines of thought. http://hjluks.posterous.com/patient-centric-care-and-the-personality-of-a
The objective of professional physician-patient interaction is treatment of the patient. Therefore, patient’s responsibility is to give any and all information/knowledge about his condition to the physician to receive best treatment. Armed with this information and observation of patient condition, the physician creates a treatment plan. This plan is to communicated to the patient with the caveat thatthe the quality and content of instructions must be limited by the patient’s capacity and interest.As an informed patient, I want to utilize all the communication tools to receive comprehensive and timely treatment from the physician. Hopefully, my physician will have the incentive and time to communicate with me via email, twitter, video chat. This is one patient’s Point of View (POV) which may not be true of all patients as you have mentioned in your article.
Thank you for your comments…. Sent from my Verizon Wireless BlackBerry
Excellent summary, Dr. Luks…I deal with these issues in my practice on a daily basis. My personality is actually well-suited for the patient who wants to know “everything”. I am most uncomfortable with the patient who just says “Whatever you think is best, doc”.Earlier this year I found myself in a place where *I* needed surgery and was seeing a professional colleague that I have worked with for years. Strangely enough I found myself playing the role of the latter (“Whatever you think is best, doc”) patient. Interesting.The challenge to physicians is our fear that differential counseling will open us up to criticism and liability. (ie is it right to give more information to the obsessive evidence seeking patient while giving less informatin to a patient like… well, … me!)
C.O. It truly is a dilemma. Many of us have had patients in our offices who are facing surgery, and do not want to know anything about it… others want to know everything. Last week I had someone ask what brand sutures I was going to use !!!!! I like your term *differential counseling*. I’ve seen too many patients suffer from analysis paralysis following my efforts to offer them numerous choices… and I’ve not been comfortable operating on patients who insist that we do not need to discuss *this* further. This is a very interesting area for the health care social media crowd to address… e
What a fantastic graphic – such a complex issue so elegantly described. Although, in a world of information overload, it’s not surprising that most people don’t have the time/patience/literacy to dig into the thicket of often contradictory medical information.I try to help friends and family prepare for the “big” visits – usually to specialists – by making a one-pager of their existing diagnoses, treatment plans, prescriptions and supplements, symptoms, family histories, etc. to organize their information and show to the doctor if they’re interested. I also separately lay out the potential treatment plans – mostly so they are familiar with the medical terms before they go into the visit. I often wonder what information doctors really want from patients. Many more patients would arrive prepared if they knew what doctors were looking for. It seems to be all over the map.
Deidre… Phenomenal comment… and that is exactly the reason I posted this a few months back… http://hjluks.posterous.com/new-patients-are-you-prepared-for-your-visit
Dr. Luks> If a ‘prepared’ patient creates a win-win situation, then what are the reasons that the type of questionnaire forms you have on your website, are not popular with other physicians? On a similar point, you have graciously stated that you do not expect reimbursement for email communication with the patients because office efficiency more than compensates for your time. Then, what are the hurdles to propagate this channel to other clinics?Thanks in advance!
Sushil… perhaps we should talk?
Howard, I like this simple graph a lot. The thing is, if we could somehow focus on only “useful” or “correct” information, perhaps the curve would take on a unidirectional form.
Maybe the greater problem patients and doctors face is data quality – not knowing what’s valid, and what matters – rather than the sheer volume of information.
I agree… perhaps that why I recently put this up… http://goo.gl/k6GnS thoughts?
thanks for stopping by!
You may also need to think of the legal implications of operating on a patient who declines information. To what extent can the said to be consenting?
Very true… that said, I would not operate on someone who was not willing to listen and understand the risks involved in the decisions that they choose to make. Good surgeons know how to get out of many problems during surgical procedures…. master surgeons, know who not to operate on.