The limitations of communicating risk

The New York Times Well blog had an article earlier this week about how elite athletes continue to use performance enhancing drugs, despite the known risk. One study mentioned in the article compared attitudes to non-athletes and were astonished at the difference in attitudes toward taking risks if it will enhance performance. Elite athletes are more willing to take huge risks.

Practitioners and physicians would do well to keep in mind that risk tolerance is not universal. Some people may have different motivations for taking risks. If the motivation is strong enough, say the motivation to win an Olympic gold medal, no amount of communication may talk that athlete out of a big risk.

Measuring what it takes to be a good doctor

Dr. Pauline Chen's Doctor and Patient column in last week's New York Times explores the tests that act as gatekeepers for those who would pursue a career in medicine. The tests are used, in part, to determine who has what it takes to be a doctor. But do these test miss some key component of personality when it comes to measuring who will be a great doctor? Or is knowing the right answers on a test more important than any measure of personality?

Putting off difficult discussions

The New York Times had an article earlier this week about the difficulty physicians have with discussing end-of-life care treatment with terminal patients. The conversations are difficult, but important, and include such decisions as aggressiveness of treatment, resuscitation and hospice. Guidelines dictate that such discussions take place when the patient has a year left to live, so the patient can make decisions along with their families. But many physicians fail to have those conversations until much later. It is easier to suggest more treatment than to have a difficult conversation with a patient about his or her impending death. But failure to have those conversations may result in more aggressive treatment than a patient desires and death in a hospital when a patient would have preferred the comforts of home. While the conversations are difficult, physicians who learn to have these conversations help their patients live their last days as they wish.

The power of non-verbal communication

As a teacher, I love light bulb moments - the moment when you can almost see a visible light turn on a students face; the moment an abstract concept becomes concrete. The New York Times Cases section has such an article today: a first year resident learns the power of non-verbal communication in conveying caring to a dying patient. Effective, compassionate communication goes beyond learning the right words from a textbook. Real communication requires seeing, feeling and giving time.

The toll of malpractice

Between the holidays and teaching at Marquette University I have still had time to keep an eye out for insights into physician and patient communication. The New York Times had an interesting article last week about the emotional toll a medical malpractice case can take on the physician involved. While the article does not offer any solutions to how malpractice cases are handled or how they should be handled, the article does offer insight into how the cases affect physicians and how the possibility of future malpractice suits affects how physicians communicate with their patients everyday.