Notes from a Family Meeting is a newsletter where I hope to join the curious conversations that hang about the intersections of health and the human condition.
I once spent a little bit of time googling how much training IM residents get in therapeutic communication and motivational interviewing. I couldn't actually get an answer from which I deduced, perhaps inaccurately, that they don't receive such training. When I did the same search for nurses I got about 8 billion hits (exaggeration but you know what I'm saying).
I speak jargon. Jargon will never be a problem for me. I literally love it and I have been asked if I have medical training just because I used the right words. The real problem is doctors do not want to tell you the truth. It's probably filed away under a subheading of beneficence in the shadowy corners of the doctor's mind.
The BMJ article you linked made an interesting proposal:
"Solutions to the problem of collusion between doctor and patient require an active, patient oriented approach from the doctor. Perhaps solutions have to be found outside the doctor-patient relationship itself —for example, by involving “treatment brokers.”"
"The real problem is doctors do not want to tell you the truth. It's probably filed away under a subheading of beneficence in the shadowy corners of the doctor's mind."
Probably.
I think clinicians also struggle to know what's "true" in the best sense of the term. As I mention in the essay, it is indeed true that this woman's kidney function is "better." Is that a truth worth sharing without contextualization? Some clinicians just share the data and leave the patient and family to connect the dots.
Residents across the board do not get any communication training. This probably contributes to their struggle to contextualize information for clinical decision-making - so either they unload a bunch of disparate data, or they withhold key information (e.g., the patient is dying) because they're uncertain or fearful.
I once spent a little bit of time googling how much training IM residents get in therapeutic communication and motivational interviewing. I couldn't actually get an answer from which I deduced, perhaps inaccurately, that they don't receive such training. When I did the same search for nurses I got about 8 billion hits (exaggeration but you know what I'm saying).
I speak jargon. Jargon will never be a problem for me. I literally love it and I have been asked if I have medical training just because I used the right words. The real problem is doctors do not want to tell you the truth. It's probably filed away under a subheading of beneficence in the shadowy corners of the doctor's mind.
The BMJ article you linked made an interesting proposal:
"Solutions to the problem of collusion between doctor and patient require an active, patient oriented approach from the doctor. Perhaps solutions have to be found outside the doctor-patient relationship itself —for example, by involving “treatment brokers.”"
"The real problem is doctors do not want to tell you the truth. It's probably filed away under a subheading of beneficence in the shadowy corners of the doctor's mind."
Probably.
I think clinicians also struggle to know what's "true" in the best sense of the term. As I mention in the essay, it is indeed true that this woman's kidney function is "better." Is that a truth worth sharing without contextualization? Some clinicians just share the data and leave the patient and family to connect the dots.
Residents across the board do not get any communication training. This probably contributes to their struggle to contextualize information for clinical decision-making - so either they unload a bunch of disparate data, or they withhold key information (e.g., the patient is dying) because they're uncertain or fearful.