Can improved communication lead to a decrease in defensive medicine?
“There is just this lack of communication between the patient and the physician, and because of this communication gap, we have physicians practicing defensive medicine — ordering those extra tests out of fear they might miss something. This has paralyzed medicine. When something bad happens, no one talks.”
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{ 7 comments }
Can improved communication reduce defensive medicine? No. To the extent it exists, and none of us know that, it is a reflection of irrational physician fears.
And, given that physicians aren’t compensated for increased communication, they are not going to do it.
I think it could. Especially if doctors were to spell out the probability of the patient’s having a desease and the risks of a specific test. How much time does it take to do to say “the chance you have desease X is …”, if I do this CT, there is this chance of your getting cancer n years from now” or “n% of people who get this test get a false positive result, the test to evaluate false positives have x% probability of …”. The whole of 2 minutes? I am sure many people wouldn’t want to have a test to rule out something they have 1/1000 chance of having if the chance of something bad happening as the result is comparable. So yes, I think communication can reduce unnecessary testing.
Doctors can communicate the things you describe now.
Then why don’t they?
1. because not everyone wants that same information
2. different persons have different interpretations of “chance”
3. patients dont show up tagged in the forehead: “i am the type who likes to know my chances” or “i am the type who wants you to tell me what to do, because i cannot depend on myself to make choices”
4. a host of other reasons that are too hard to discuss in limited time frames in consideration of the other waiting patients
Anon 2:24, the answer is because they don’t get paid to do so. Incentivize communication, and you will get more of it.
“Incentivize communication”-are you kidding? We are going to pay docs more for talking with their patients and being honest? What is this profession coming to?
An apology bill should not be implemented to get physicians off the hook and give them legalized immunity when an error was made and they decide to apologize. This legislation should be in the patient’s best interest who has experienced the adverse event.
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