Penn study: patients more satisfied with treatment when part of decisions
Increasingly, physicians are realizing patients get better care when they move away from the paternalistic attitude of 'doctor always knows best.'
A new study by researchers at the University of Pennsylvania has found that cancer patients undergoing radiation are more likely to be satisfied with their treatment if they have more of a dialogue with their doctors.
Neha Vapiwala, a radiation oncologist and senior author of the study, said this type of shared decision-making might be as simple as the physician explaining the pros and cons of a particular drug, and asking the patient for input.
"No matter how busy you might be in your clinic, and no matter how pressed for time you are, it's important," Vapiwala said. "Even if you take just two to five minutes to involve the patient in something that might seem like a minor decision to you, it's amazing how far that could go."
In her survey, Vapiwala found that 84 percent of patients were satisfied with their treatment if they took an active role in decision-making, compared with 71 percent who did not. She found similar boosts in satisfaction when patients felt they had control of their treatment, regardless of whether they said they wanted to have control. Patients who wanted to be in control of their treatment — but didn't feel they were — were more likely to be tired, depressed, and anxious.
Other studies have investigated the benefits of shared decision-making in other subspecialties of medicine, but Vapiwala said this is the first one to apply to radiation therapy, which is prescribed for nearly two-thirds of all cancer patients.
Vapiwala has yet to find out how participation in medical decisions affects how cancer patients fare long-term, but she suspects it could play a large role. Radiation treatment in particular is highly technical and often requires repeat visits, so keeping patients informed and comfortable is critical.
"If you don't have a patient who fully understands and is not fully vested and fully engaged in this, it can hurt — and missing treatments is very detrimental to outcome," she said.
While some of these strategies seem like common sense, Vapiwala said they're not taught in most medical schools, and the current medical system doesn't reward doctors for the extra time they require.
Recognition of the problem, however, is increasing. A section of the Affordable Care Act allows for the creation of a shared decision-making program, and a recent report by the Institute of Medicine advocates dedicating more resources to improving patient communication.