Talking to children about genetic test results

Genetic screening presents a unique communication challenge, in that the results do not only affect the person being screened, but may also have implications for family members who share that person's genes. The Wall Street Journal Health Blog reports on a recent study of how and what parents tell their children about screening results for the breast cancer gene. It's not surprising that typically children's reaction are in proportion to what they are told. But this study starts an important ongoing communication conversation that physicians, genetic counselors, and patients need to be aware of. Physicians and genetic counselors need to be aware that when they are counseling a patient, the words may get passed on to others. And patients need to consider what their family members want to know before discussing genetic tests.

When recommendations change

The American Academy of Pediatrics released new recommendations today regarding children and car seats. As is often the case with science and medical research, new data emerges and the recommendations that were standard for years can change, seemingly overnight. I make note of this, not because of the change in recommendations, but how personally some parents seem to be taking it. A quick glance of the comments section on New York Times article show parents up in arms about the recommendations, and others chastising those parents for not being concerned enough about their child's safety.

For physicians and nurses who communicate such recommendations to parents, this reaction points to the importance of sensitivity when making recommendations. It is easy for parents to take recommendations as a personal affront to their parenting skills. A little sensitivity and validation of those feelings may go a long way in getting parents to thoughtfully consider a new recommendation.

When a physician is not a physician

The New York Times Well blog is running a series of articles from cancer researcher Dr. Peter Bach. But Dr. Bach is not offering his perspective as a physician or as a researcher, but as the husband of a wife facing breast cancer. It is a unique perspective: objective clinical knowledge and the raw emotion of seeing a loved one in poor health.

This week, Dr. Bach discusses the complexities and emotions of involvement in a clinical trial. It is one thing to objectively understand the reasons for a double-blind study, where a new treatment is compared to standard care. It is another to be the loved one of a patient hoping that your loved one gets the new drug and that it might be just a little better than the standard care. The article, and other that have explored why patients participate in clinical trials, demonstrates that it is perhaps impossible to be totally objective when discussing cancer research. Patients and physicians will always hope that they will be the exception.

Tension at the Thanksgiving dinner table

The New York Times Well column this week reflects on the tension that sometimes joins the family at the holiday table. In particular, issues surrounding food, portions, control and preferences, can cause anxiety when families join together for a big meal. The article illustrates that health messages are not always healthy and that the messengers aren't always health professionals. We should all remember there is power in our words.