Blog | Monday, November 12, 2012

QD: News Every Day--Plan for patient preferences


To make accurate treatment recommendations, physicians must better diagnose patients' preferences, according to a recent paper.

Three experts from the Dartmouth Center for Health Delivery Science suggested that many physicians who believe they consider patients' preferences may be operating on incorrect assumptions. For example, the authors said, one study showed that while doctors thought 71% of breast cancer patients viewed keeping their breast as a top priority, only 7% of patients actually did.

The authors recommended a three-step process for making a "preference diagnosis":

1. Adopt a mindset of scientific detachment.

2. Formulate a data-based provisional diagnosis.

3. Engage the patient in conversation and deliberation.

A mindset of scientific detachment helps physicians to eliminate bias, the experts said, while data, if available, might help them determine what the patient's decision is likely to be. Finally, engaging the patient in team talk, option talk, and decision talk can help ensure shared decision making.

The authors suggested that better diagnoses of patients' preferences could not only improve care but also save costs. "Evidence from trials shows that engaged patients consume less healthcare," they wrote. "More work is needed to understand the magnitude of this potential benefit, but it is tantilising to consider that budget challenged health systems around the world could simultaneously give patients what they want and cut costs."

The paper was published online Nov. 8 by BMJ.