Room For Growth In Doctors Facing The Tough Stuff

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A few weeks ago, STAT News released two closely related opinion pieces. One discussed how doctors need to be more transparent and honest about mistakes and near misses, and another had put forward that they need to be better trained to speak frankly about death. Both hang on a common moral implication: that communication in healthcare settings is so important, no aspect of reality should be exempt from transparency.

To put it into perspective, we might look at the recent ad campaign by Truvia, which has been under attack by oncologists for promising too much, and being misleading. “Sharon was given a few months to live,” it says. “One year later, she’s here to tell her story.”

The ad ignores the reality that this is not the outcome for many cancer victims, and we might become angry that it creates hollow product biases in patients, flying in the face of an objective prescription process from a doctor.

But if we’re to express distaste at how an ad creates false hope, we should hold doctors to the same standards. Mistakes should be discussed and openly identified, and death should, unfortunately, be a necessary conversation for some. To not be straightforward might cause more than false hope in a patient, including total misunderstanding of the severity of a medical situation.

According to a Kaiser Family study, most Medicaid patients desire to talk about preparations for death with their doctors, but only 17% had their wishes granted. Meanwhile, a 2013 National Healthcare Quality Report suggests the majority of healthcare workers believe their mistakes will be held against them. It’s a paralyzing and systemic fear that halts discussions with colleagues and patients alike on how to improve and/or change direction.

Ignoring or hiding from the difficult conversations can be just as detrimental to a patient’s experience as false hope, as it shirks important realities that need to be taken into consideration for next steps. An article by Scientific American makes the crucial point that “our own resolved and unresolved emotions shape our interactions with patients and families,” and to leave information out or dodge discussions is to leave potentially crucial interactions unattended-to.

Thankfully, many training programs like the SHARE simulation lab are training medical professionals to have difficult conversations with dignity and honesty. Doctor-patient relationships also continue to be a growing field of necessity in healthcare settings.

Medical professionals need to ensure that while we fight for a future of promising direct care and disease cures, we need to simultaneously grapple the realities of the present. Patients simply deserve it.