Do patients bond best with doctors who misinform them with optimism?

thesituationist.wordpress.com

Good commentary on the recent study (When Treating Cancer Is Not an Option) showing that many terminally ill cancer patients believed chemo could still cure them. In addition to other factors such as the optimum bias, one additional possible reason:

One final worrisome finding is that the patients who reported better scores for how well their physician communicated with them were less likely to give accurate responses for the goals of chemotherapy. That means that patients who best understood that chemotherapy could not cure them reported that their physicians were worse communicators than patients who misunderstood their likelihood of cure. Does telling bad news inevitably strain the physician-patient relationship? Do patients bond best with physicians who misinform them with optimism or allow them to misunderstand important aspects of their care?

As patient satisfaction surveys begin to play a larger role in physician compensation we may ironically find that doctors will be increasingly paid to cater to patients’ unstated desire for misinformation.

Do patients bond best with doctors who misinform them with optimism?.

Some patients need absolution, not medicine

feeding-his-sheep.blogspot.com

Some reflections by a doctor on the limits of what he can do for his patients who feel guilt or remorse when they have done wrong. Quote:

What’s the medical specialty that helps people who’ve done wrong? What’s the service industry that undoes guilt? I’m no expert, but as far as I can tell, the only methodical approaches to this are in organized religions. My colleagues and friends who are psychologists and psychiatrists may object. But it seems to me that mental health professionals can only clarify the patient’s goals and feelings, clarify if the ethical damage can be undone, and work through the feelings. That’s a lot, but it doesn’t strike me as what these patients are craving. They want to atone. Organized religions have a formula for that.

I’m not here to tell you to go to church. And I’m certainly not going to delve into theology or suggest that any religion’s recipe for forgiveness is true in a fundamental or exclusive sense. I’m just suggesting that if you know you’ve done something wrong, and you feel terribly about it, maybe you don’t need a doctor. Maybe you need a minister, a priest, or a rabbi.

Like I said, I love what I do. I can fix some medical problems, and I can help prevent others. I can help you live more days and make those days healthier. But there is more to life than that. Sometimes there is also wrongdoing, and guilt, and redemption. For that, I have no training. Forgive me.

Some patients need absolution, not medicine.