Doctors: Manage our Expectations, please!

That’s the theme that popped up time after time, segment after segment, this morning as we taped my weekly radio show

One interview took place with Dr. Dale Avers, an associate professor of the physical therapy education program at SUNY Upstate. Our conversation on the show was about total knee replacement and the physical therapy and exercise patients need to do post-surgery.  She said patients never understand what they are in for when it comes to the exercise they need after the surgery.  The complaint she hears repeatedly from patients is, “My doctor never told me that!” 

I also interviewed Dr. Robert Carhart, a cardiologist at University Hospital in Syracuse, NY who was helping us look behind the New York Times story about stents /angioplasty /cardiac catheterizations vs heart bypass surgery.  New research is telling us that in the rush to make procedures “easier” for patients by using angioplasty and stents, many patients end up with bigger problems down the road that bypass surgery would have avoided. 

In both cases, problems stemmed from patients who just didn’t have enough information before giving their “informed consent” for those procedures.  In both cases, patients did not do well enough post-surgery because they didn’t have the information they needed prior to their surgeries. In both cases, patients did not know what to expect — and that’s because doctors didn’t tell them.

Remember informed consent?  Patients thought they were informed, they gave consent, but in both cases, they weren’t really informed at all.

So what can be done about that? 

Doctors:  YOU are the ones with the knowledge.  and YOU are the ones who can manage our expectations.  When it comes to any kind of treatment — or even a test — tell us what to expect!  Having that knowledge helps us make better decisions and helps us find better outcomes.

Patients:  WE are the ones who need to ask!  Doctors are in too big a hurry — they don’t have time to think up our questions for us.  If you are presented with any kind of test or treatment option that you know will be at all difficult or invasive — then ASK WHAT TO EXPECT!  What will happen before?  What will happen after?  What will happen during?  What are your responsibilities in the meantime?

And, patients, make sure to get a second opinion before you undergo any kind of invasive test, procedure, treatment or surgery.  That’s an even more troubling conversation that took place about doctors who profit from their recommended treatments.  Stay tuned!  I’ll share that one with you tomorrow.

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