tag:blogger.com,1999:blog-4968787219619380438.post2885036720012921653..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: More on Patients and “Shared Decision Making”Skeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-4968787219619380438.post-64335152214059979452012-09-05T07:33:41.109-04:002012-09-05T07:33:41.109-04:00I agree with you. For many of the things we do,esp...I agree with you. For many of the things we do,especially emergencies, the patient has little choice. I do tell them that observation is an option. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-91440504792885305382012-09-05T00:12:52.771-04:002012-09-05T00:12:52.771-04:00This may be a bit pompous, but I often tell patien...This may be a bit pompous, but I often tell patients, "Look. . .you have a bad (gallbladder/appendix/colon, etc.) and the only treatment is surgical in 2012. You don't really have a choice--unless you want to just go home. Sure there are risks...bleeding, infection, death...but you HAVE to accept this because, unless you're calling a cab, let's go to the operating room."<br /><br />The patient almost always say, "Thanks, Doc...you're right...where do I sign?"Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-81108373424619631322011-08-31T13:04:43.972-04:002011-08-31T13:04:43.972-04:00Thanks for commenting.
I agree surveys can be man...Thanks for commenting.<br /><br />I agree surveys can be manipulated but 67% qualifies as "most" to me.<br /><br />I agree that when two treatments have equivalent results, a patient who understands the risks and benefits of both can certainly choose.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-32677140276041051432011-08-29T09:15:48.760-04:002011-08-29T09:15:48.760-04:00A phrase in the last sentence of the abstract of t...A phrase in the last sentence of the abstract of the U of Chicago study you cite was telling: "effect was small." In survey work it's easy to come to the wrong conclusion by asking questions in the wrong way, so I guess I'm less persuaded by this study that most patients want the doctor to make important decisions. Many patients, yes, of course. Most? Maybe not. <br /><br />More to the point, should you the physician be making decisions for patients about elective procedures? For instance, should you decide whether or not a woman with early stage breast cancer gets a mastectomy or lumpectomy with radiation? They are equivalent in terms of mortality benefit, but obviously very different in terms of their effect on the woman's life.Shannon Brownleehttps://www.blogger.com/profile/02830276421398983266noreply@blogger.com