IOM paper finds docs don't adequately mitigate patient desire for options, evidence


Patients have spoken and are eager to hear back.

[See also: IOM report aims to treat ailing healthcare system with new industry tactics ]

So says a new discussion paper released by the Institute of Medicine (IOM) on Sept. 25, which considers the results of Consumer Reports National Research Center surveys and other input when suggesting that better communication between provider and patient is necessary to enhance the current healthcare system.   

"Doctors take note: People want – and deserve – meaningful engagement in conversations about their care, and they value it when rating their experience of care," John Santa, MD, director of the Consumer Reports Health Ratings Center and co-author of the IOM paper, said in a news release. "They do not want their practitioner to make decisions for them or offer only some of the options."

Analysts found that of the patients surveyed, 8 out of every 10 admitted to wanting their healthcare provider to vent rather than circumvent when discussing diagnoses and conditions. Yet, just 6 in 10 contributors felt their providers actually listened and only 4 in 10 said their physicians took the time to explain the latest medical evidence clearly. Furthermore, less than half of the subjects reported sufficient dialogue with their providers regarding goals and concerns for personal health and healthcare. Such blatant disconnect between what is desired and what is delivered let the IOM collaborative know that current communicatory techniques are not at the levels they should be, and thus, require tweaking.  

[See also: Successful care transitions hinge on communication]

"The gap between what people want and what they are getting leads to poor medical decision-making, but it also represents an opportunity to do better," said George Halvorson, chairman and chief executive officer of Kaiser Permanente and co-chair of the IOM collaborative, to the press.  "We know how to get it right -- with shared decision-making between patients and clinicians that produces informed decisions."

Paper authors listed these three dialogue dos for physicians to consider when improving their conversation methods with patients:

  • Supply patients with updated, reputable medical evidence.
  • Make sure counsel to patients is sound, unbiased and tailored to that specific patient’s needs and condition(s).
  • Respect in full the patient’s and their family’s goals and concerns.

When prompted about shared decision-making, the IOM report deemed that the public, overall, does not consider outside evidence as representative of cookbook medicine. A survey conducted in the Spring of 2012 by Consumer Reports for IOM revealed that of the 1,068 patients queried, most believed that outside evidence surrounding their conditions was more important than their doctor’s and even their own guidance.    

All in all, the collaborative believes that changes in communicatory practices are not only simple, but the right course to pursue.

"We need to make it easy to do the right thing by encouraging, empowering and motivating clinicians to facilitate informed medical decisions whenever and wherever they practice. Policy can foster this by changing the way we pay for care, by promoting high-quality tools to help clinicians inform patients, and by educating clinicians about best practices for communicating with patients," Bill Novelli, a professor in the McDonough School of Business at Georgetown University, former CEO of AARP and co-chair of the collaborative, said.

Research was provided by MSL Washington, GYMR Public Relations, Lake Research and Consumer Reports.

Find the full discussion paper and list of author contributors here. [See also: IOM report recommends primary care and public health collaboration]

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