Doctor and Patient: Afraid to Speak Up at the Doctor’s Office – NYTimes.com

A good piece on the patient-doctor relationship, and how patients feel uncomfortable asking their doctors about treatment alternatives. Quote:

The participants responded that they felt limited, almost trapped into certain ways of speaking with their doctors. They said they wanted to collaborate in decisions about their care but felt they couldn’t because doctors often acted authoritarian, rather than authoritative. A large number worried about upsetting or angering their doctors and believed that they were best served by acting as “supplicants” toward the doctor “who knows best.” Many also believed that they could depend only on themselves for getting more information about treatments or diseases. Some even said they feared retribution by doctors who could ultimately affect their care and how they did.

The gap between the patients and doctors perceptions was striking, as doctors largely feel they are already doing shared decision-making. What makes this study interesting is that most participants were affluent, well-educated and over 50 – precisely the group that should be most comfortable, and most likely to view themselves as peers to doctors.

My own experience with my decision tree was open and joint. Yes, I was ‘steered’ toward having the allo SCT, but it was done in an open and joint manner. And as in my case, as in general, this takes time:

“We urgently need support of shared decision-making that is more than just rhetoric,” Dr. Frosch said. “It may take a little longer to talk through decisions and disagreements; but if we empower patients to make informed choices, we will all do much better in the long run.”

Doctor and Patient: Afraid to Speak Up at the Doctor’s Office – NYTimes.com.

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