Wednesday, April 29, 2009

Getting bad medical news

But first a word on swine flu. Whenever I hear more of the insane media hype on swine flu, all I can think of is Kevin Bacon at the end of Animal House:

I have seen much debate recently on how one should receive bad medical news. (No, I have not recently received any bad medical news.) Basically Parade Magazine, that intellectual publication, had an article and online poll in their most recent issue. Currently 78% for in person vs. 22% for over the phone. Then the Livestrong blog picked this up as well and continued the debate.

I disagree that there is a generic right or wrong way to tell a patient the news. the correct answer to this debate is 'whatever the patient prefers'. At this point in my life, if I have a procedure, operation, biopsy, etc. one of my first questions is when will the results be ready and how soon can I get them. I often get the standard reply of 'you will get the results at your follow up appointment'. Well, I don't want to wait that long, when do you think you will have the pathology. Then I get usually get told a much shorter time frame. Sorry, cancer twice and I am not waiting two weeks to be told my biopsy results - especially when I know the doctor's office gets them much sooner.

At my gall bladder surgery, I asked and was told I would get the pathology results at my follow up two weeks later. I said that was too long, when would they be available and was told something like 3 days. Well on day four I called and asked and the doctor called me back that day. I was much less stressed than sitting around for another ten days waiting to hear. Also, that way if it was 'bad' news, I had time to stew and digest and learn and educate myself so at my follow up appointment I would be armed with questions and then leave with more of a treatment plan.

If you prefer to get the information at an appointment that's fine. That's your choice. There is no one size fits all in medicine and everyone has their own wants and needs. Every cancer is different and so is every patient. As a patient, you are responsible for making sure your doctor understands your needs and how and when you want to be told about your diagnosis. Don't fall into the trap of their standard procedures. If your doctor tells you that you must come in for an appointment to get the results and you don't want to wait that long, ask them why that is the case. There should be some consideration of the patient here.

I am all for empowering the patient but the patient needs to make sure they stand up for their rights and asks about options.

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