The Boston Globe has a revealing article about a study published in Annals of Internal Medicine where patients thought that a heart stent would help prevent another heart attack. But doctors had only told patients that it would relieve future chest pain. How can such a communication disconnect still happen in this modern age of medicine? Read the full article, Study finds doctor-patient disconnect.
John M. Grohol, Psy.D.
John M. Grohol, Psy.D. is one of the pioneers in online mental health and support groups, getting his start on the Internet in 1992 with depression support groups and advocacy efforts. He is a writer, researcher, and the publisher & founder of the Internet's leading mental health and psychology network, Psych Central, a founding corporate member of the Society for Participatory Medicine. Dr. Grohol sits on the editorial board of Computers in Human Behavior and does e-health consulting in his spare time.
Dr. Grohol is a founding member and treasurer of the Society for Participatory Medicine, and is also a member of the Association of Health Care Journalists.
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I’d like to comment but this isn’t about a stent.
I have pelvic pain & I was given an option of a hysterectomy for adenomyosis. many of the articles brag up the LAVH, they make it sound so easy & less invasive & have testimonials about how quickly people go back to work.
Might be true, but not for me, & I did laundry & things, I carried smaller loads down, but I did start bleeding.
When I explained to the doctor what I had done, he explained to me what all happened on the inside & explained that recovery needs to be taken seriously especially with my history of adhesions.
More recently with my mom, she had a toe removed & during her recovery he would tell her she could be up & around on the toe but not long & keep it elevated. So my mom vacumed & had lots of pain, To him “not long” meant 5 minutes out of an hour, To mom an hour on & 10 minutes off seemed ok.
As for my hysterectomy, I wrote the hospital a letter, not to complain but maybe to clarify on discharge notes, I felt great when I got home, I didn’t remember them giving me any pain meds, but when they wore off, playing “catch up” on the pain meds was incredible. My BM’s were very painful & I found out that was normal, and my horrible headache, was normal because of the position I was in for the hysterectomy.
My recovery was not nearly as easy as the testimonialt where the lady was back to work in 4 days.
I’m sure doctors are so use to seeing recovery time but a hysterectomy for me is a 1 time thing & I wasn’t on the same page as my doctor.
I survived & did go back to have adhesions removed my ovary was attached to my bowel, it’s just my version of “easier surgery”was way different than the doctors meaning.
Diane
The article has one major defect: The abstract says specifically:
Limitation: The study was small and conducted at 1 center, and information about precatheterization counseling was limited.
In other words, be careful with the conclusions! Unfortunately, the Boston Globe doesn’t mention this limitation at all. Instead, the subheading says “Many stent recipients overestimated results”.
I can’t trust an article written in this fashion. It is fundamental, when reporting this kind of study results, to be accurate.
That said, a bigger study, published a week ago, produced even stronger evidence that doctors and patients are on a major disconnect course. And nothing will change until doctors learn to blame themselves or at least how they learned to communicate and NOT LISTEN to the patients.
Interesting that I should find this article right after the blog I posted (mylifeafterdeath.tumblr.com) about my husband and his diagnosis of CAD. My husband had stents five years ago, suffered a massive heart attack on January 16, died on May 1st and we never knew he had ongoing heart disease! As your article stated we had no idea the stents weren’t the cure. He was completely compliant with doctors orders taking all meds prescribed by both his endocrinologist and cardiologist, kept himself fit, regularly went for check-ups and still we didn’t know that time was running out.And yes, I do feel the doctor had the responsibility to explain the things we needed to know. Who knows maybe we would have had life insurance!
History, goes the mantra, is written by the victors. Similarly, medical study results are written by the folks with the medical degrees. Gilles is correct to point out that the study is narrowly limited. I would add that the results are interpreted by doctors for doctors. A less biased position would be that the study suggests a communication disconnect.
Is it surprising that patients misunderstand what doctors tell us? They keep us waiting in their cold examining rooms, several minutes past the time I was supposed to be back at work, and then they rush in, ask a few questions, talk over our attempts to answer, ask if we have questions, again talk over our attempts to answer, and then leave, satisfied that their job is done–that they’ve properly informed us. Six months later, they’re saying, “No no no, that’s not what I told you.”
I’ve been considering a series of blog posts on what doctors mean when they say______. Looks like I should add “What doctors mean when they say, ‘patients misunderstood.'”
Looks like Gilles nailed this one all ways ’round.