-- Robert Preidt
FRIDAY, Nov. 9 (HealthDay News) -- Doctors often ignore or
misunderstand what patients want in terms of treatment, and this
"preference misdiagnosis" can be harmful to patients, experts
The authors of a new report say a doctor cannot recommend the
right treatment without fully understanding a patient's
preferences, yet evidence suggests there are often large gaps
between what patients want and what doctors think they want.
For example, one study found that doctors believed that 71
percent of breast cancer patients rated keeping their breast as a
top priority, but the actual number was just 7 percent, said Albert
Mulley from the Dartmouth Center for Health Care Delivery Science
in Hanover, N.H., and colleagues.
Another study found that patients with dementia placed much less
value than doctors on staying alive with severely declining mental
function. And a third study found that patients may change their
treatment preference when informed about its risks and benefits.
For example, 40 percent fewer men preferred surgery for benign
prostate disease after they learned about the risks of sexual
Ensuring that treatment matches a patient's preferences is not
as simple as asking what a patient wants, but requires three
specific steps, said the authors of the article, published online
Nov. 8 in the
The three steps are: a mindset of scientific detachment; the use
of data to arrive at a provisional diagnosis; and including the
patient in three phases of decision making -- team, option and
Along with being the ethical thing for doctors to do, fully
understanding patients' preferences may also help reduce
health-care costs, the researchers said. They noted that studies
show that engaged and informed patients often choose to have
less-intensive care and are more careful about having lots of
"It is tantalizing to consider that budget-challenged health systems around the world could simultaneously give patients what they want and cut costs," the researchers concluded in a journal news release.
The American Academy of Family Physicians offers tips for
talking with your doctor.
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