Kevin, MD has posted about communication and medical malpractice today, linking an article in the online Medical Economics magazine that is about avoiding medmal litigation.

In his post, “Controlling patients’ expectation,” he mentions “a core tenet of risk management,” which is to communicate realistic hopes and fears about a test or treatment by taking time to engage in some conversation about what is reasonable. According to the article, “Are You Raising False Hopes? What you say about treatment risks could come back to haunt you,”

“The surprised patient is often an angry patient who mistakenly assumes that a bad outcome shouldn’t have happened and his doctor therefore must have done something wrong,” says [San Francisco GP and JD Dan] Tennenhouse, who lectures on healthcare legal issues at the University of California, San Francisco, and in Kaiser Permanente facilities. “So he sues for malpractice, but the root of the lawsuit is in the informed consent process.”

The article goes on to identify “ways that doctors inadvertently lead patients to expect too much from proposed treatment,” and to give “stratagems to set patients straight.”

These suggestions are well worth reading. Some of advice involves making sure doctors express statistical facts in a way the patient can grasp.

put expressions of relative risk such as “Drug XYZ reduces the chances of such and such disease by 50 percent” into context, he says. A patient may find this benefit compelling, but for a better understanding, he also needs to hear about the absolute risk. How many people in 10,000 normally contract the disease when untreated, and how many do so on the medication? Let’s assume the medication reduces the number from 2 in 10,000 to 1 in 10,000. A patient may have second thoughts about taking it, particularly if it comes with a high risk of debilitating side effects.

Read the whole article.