Doc, please give me a good answer.

My May 19th post -- "Doc, how much time do I have?" -- I offer some ideas about why a physician might tell a patient how much time he or she has left. I concluded by posing a question: How should physicians answer that question?

Commentor Finn offered an excellent answer that I'll share here, with my highlights: "I think they should preface their reply with "Of course no one can say for sure. All I can tell you is that among people your age and condition, at this stage of the disease when treatment stops working, the average is ____________ [a range].

However, it can be shorter or longer. These are statistics about large groups of people, and not specific to you or any one individual. They can't predict what you will experience."

Finn goes on to say, "It might be even better to start with explaining what the patient should expect in terms of energy, symptoms, debility, etc., as the disease progresses, before talking about numbers.

I haven't been in this situation but I'm thinking people ask the question because they want to know what to expect, to help them make decisions and plans, and not just a date. I think doctors should neither dodge the question nor be overly specific or confident in the times they give, but they do owe it to the patient to do what they can to explain why such predictions may be educated guesses but are nevertheless guesses."

Thank you, Finn.

Comments

[Lisa Cunningham]

This is a fine line to walk, to be sure. The doctor wants to be relatively honest by telling the survivor what to expect and at the same time offer hope for beating what might seem like insurmountable odds.

The answers lie in teaching doctors how to communicate better during medical school. Fortunately, the newest programs are doing just that. Doctors are often accused of being arrogant, but it's important for the patient to get educated and keep asking questions even if the doctor seems annoyed. If you're not getting answers, go see someone else who will respond.

[Wendy S. Harpham, M.D.]

Dear Lisa,
Yes, there is a new emphasis on teaching medical students about effective and compassionaste physician-patient communication. I'm hopeful that ONLY 10 SECONDS to CARE will contribute toward this movement.
With hope, Wendy