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What people hear when they go to the hospital

There is an interesting study out of Boston showing the disconnect between what doctors think they are telling patients and what patients understand. Hat tip to Health News Review for highlighting the story.

The study looked at patients with stable chest pain who elected to have their arteries opened with angioplasty and stents.

More than 80 percent of the 153 patients surveyed thought the stent would decrease their chance of having a heart attack and increase their chance of surviving a heart attack. For stable chest pain, however, stents do not prolong life. The bits of metal mesh only improve blood flow and sometimes make a patient feel better. And more than 80 percent of the cardiologists surveyed in the study understood that the stents would not save any lives and the doctors thought they explained that to patients.

Here’s what UNC’s Dr. Michael Pignone had to say:

Patients are not to blame for the misunderstanding about angioplasty and stents, said Dr. Michael Pignone, a medical editor for the Boston-based Foundation for Informed Medical Decision Making and a professor at the University of North Carolina School of Medicine.

“The onus is on us as health care professionals to really drill down to what is the essential information,’’ Pignone said. “We need to learn from patients what is the most important information to them.’’

It’s difficult to know whether or not doctors are misremembering what they said or whether patients are listening to their hopes instead of the cardiologist. But we know that properly informed patients are more likely to choose less invasive procedures. That is why shared decision making is a key part of controlling health care costs.

One Comment


  1. Mike Pierce

    September 9, 2010 at 10:42 pm

    There is huge information asymmetry when it comes to a patient’s knowledge and their expectations versus what the doctor knows and can effectively communicate. It’s difficult for patients to understand the complexities of their medical condition and equally as hard for the doctor to educate them to a level that would insure they understand their treatment. On top of this, doctors have very little time to invest in educating patients.

    Patient decision aids (PDAs), educational materials (Dr. Pignone’s organization makes these in the form of instructional videos), combined with an outside doctor’s advice is perhaps the best combination for getting a patient fully informed. It’s a combination that is rarely employed, and especially not in the context of the Patient Centered Medical Home (PCMH) that is the latest push of health reform.

    At Expert Medical Navigation (www.exmednav.com), we strongly believe that PDAs, education and outside doctor advice is the way forward for helping people understand their conditions, effectively converse with their primary doctors, and ultimately make the best decisions about their health.

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