A new project at the University of British Columbia aims to bring
doctors and patients together to take a shared role in making decisions
about medical care. Research shows that patients who take a more
active role and have more information about their illness respond
better to treatment–which may result in less demand on scarce health
care dollars.
Called Informed Shared Decision Making, the project will train
physician-patient teaching teams and create educational packages
on communication skills, critical evaluation of research evidence
and decision making for physicians, patients and undergraduate medical
students.
“Patients need to be informed, and physicians need to know how
to help their patients become informed,” says project head William
Godolphin, a professor in the Dept. of Pathology and Laboratory
Medicine.
Godolphin says the project is a reflection of several trends: greater
interest in health promotion, people taking more responsibility
for their own health care, and a changing environment for doctors
in which the traditional, paternalistic model of medicine is giving
way to more consumer-oriented attitudes.
Most complaints made against physicians–80 per cent of those heard
by the College of Physicians and Surgeons–arise from a lack of
communication, he adds.
Physicians often think they give more information than they actually
do, and patients often do not know the right questions to ask.
In part, this stems from the physician-oriented communications
skills taught in medical schools, such as how to break bad news
or obtain useful information from reticent patients.
“What we are talking about is a higher range of communications
skills: decision-making aids, assessment of risk, giving patients
access to information and helping them assess it by making it more
meaningful to them,” Godolphin says.
The project will teach physicians how to assess patients’ cultural,
social, economic circumstances and their willingness to take risks,
help patients to weigh the evidence of risks and benefits in relation
to their values, and then how to work in partnership to reach a
decision about what should be done.
As well, the project team is involving patients, advocacy and community
groups, patient associations and agencies involved in patient education.
“The patient can be a powerful agent for change of physician’s
behavior,” Godolphin says.
Based in the Office of the Co-ordinator of Health Sciences, Division
of Educational Support and Development, the project is currently
funded by grants from the B.C. Medical Services Foundation, administered
by the Vancouver Foundation, and UBC’s Teaching and Learning Enhancement
Fund.
-30-
