Map of life expectancy at birth from Global Education Project.

Monday, November 15, 2010

So what the heck do I know?

I'm involved in various forms of research based on the premise that "patient centered communication" is like, you know, good. That means that doctors encourage patients to say what's on their minds, set shared agendas, engage in shared decision making, enter patients' life worlds and understand how their values and goals intersect with biomedical understanding to shape the right choices for them, yadda yadda yadda.

This is, of course, in contrast to the old idea of medical paternalism where the doctor tells us what to do and we follow orders.

So, as part of this whole program, I'm running focus groups with people with HIV to talk about their relationships and communication with their doctors about antiretroviral medication taking and other such issues of their own behavior. So what do they like? It turns out they like it when doctors scold and yell at the people who screw up. That proves the doctor really cares.

At least that's what they tend to say when I ask them. It does not follow that it works in real life, but still. The life of a social scientist is a continual carnival of surprise and wonder.

(I did two focus groups today, which is actually fairly grueling. I have to do two more tomorrow then fly back to Boston. And no, I don't get time and a half.)

8 comments:

robin andrea said...
This comment has been removed by the author.
robin andrea said...

That above missing comment was mine. It was similar to this:

This post makes me wonder if people prefer the communication models that they experienced as children.

Cervantes said...

Bingo!

kathy a. said...

maybe they read it as caring, but does it improve response? because, there is that adverse message there, "you're a jerk," which often makes me [and i'm not alone] want to run in the opposite direction -- again, by dint of early programming.

i bet those focus group sessions are draining. they aren't in a treatment context, and i'm sure personal privacy is assured, so volunteers are likely to speak out in ways they wouldn't with doctors. and then, there is the group dynamic -- people riffing off of what someone else said. a lot to process.

pharmacy reviews said...

I'm really for "patient centered communication." I personally experienced sitting in the patient's chair, talk about my symptoms to the doctor for 5 minutes, and the doctor prescribes medicines. I felt like a car going in for repairs. No human connection what so ever. Also, when you have a serious condition how can you trust someone who treats you with such detachment right? I think most patients don't heal because they're frustrated that their "healer" doesn't really care about them.

- Mamie Eldridge

JMT said...

I was reminded of you and your research on patient-doctor communications just now when I saw this post: http://mymilkspilt.wordpress.com/2010/12/22/thanks-for-your-help-doctor/

It's a little long - the dialogue toward the end is what I thought you might find interesting in particular.

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