Doctor who? Are patients making clinical decisions?

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Doctor who? Are patients making clinical decisions?

Changes in society and technology are influencing how patients see

their physicians

http://www.eurekalert.org/pub_releases/2008-02/s-dwa021108.php

Doctors are adjusting their bedside manner as better informed

patients make ever-increasing demands and expect to be listened to,

and fully involved, in clinical decisions that directly affect their

care. In a study just published in Clinical Orthopaedics and Related

Research, Dr. J. Bohannon Mason of the Orthocarolina Hip and Knee

Center in Charlotte, NC, USA, looks at the changes in society, the

population and technology that are influencing the way patients view

their orthopaedic surgeons. As patients gain knowledge, their

attitude to medicine changes: They no longer show their doctors

absolute and unquestionable respect.

Demographic change, education, affluence, availability of information

via the Internet, patient mobility, direct-to-consumer marketing,

patient age, patient activity demands, cost pressures and physician

accountability are converging to present the practitioner with a

patient who is more informed and has higher expectations than any

prior generation of patients.

Today's patients do not simply have a medical complaint, they desire

a particular operation and sometimes even a particular implant. The

doctor is no longer the sole source of medical information. Patients

have enough snippets of information to stimulate a dialogue and

clearly express their expectations for a particular outcome and

technique to achieve that outcome. They are also demanding quicker

recovery, return to higher-level sport activity and earlier discharge

from the hospital.

" Patients have come to expect miracles in medicine as the norm, yet

these miracles are not without inherent risk, " cautions Mason.

Providing true patient-centered care relies on doctors' ability to

supply patients with accurate, evidence-based information and to

improve communication. However, patients are not necessarily

motivated by evidence-based medicine. They are often willing to adopt

the promises of direct-to- consumer marketing.

In Mason's view, the doctor's responsibility is " to maintain control

of validated information sources and of the exchange of information

with the patient. [Doctors] need to be interpreters and balancers of

scientific information to help guide [their] patients through the

maze of medical hyperbole. [They] need to discuss new treatments and

technologies openly and honestly. "

And crucially, they must also understand that although patients'

demands are changing, the surgeon's accountability and responsibility

for their patient's safety and care have not.

Reference

1. Mason JB (2008). The new demands by patients in the modern era of

total joint arthroplasty. Clin Orthop Relat Res (DOI 10.1007/s11999-

007-0009-2)