The Art & Science of Prognostication Series
Lesson Two: Optimism & Pessimism
QUESTIONS WORTH CONSIDERING
4.“As a physician, I’ve often been asked why it is so important to give a particularly bad prognosis. The biggest reason is that people need a landscape. They need to know what they are walking into in order to make a plan. ” – Soul & Science Lesson
5. “Honest communication of clinical reality allows patients to make better informed decisions regarding treatment options, fully prepare for eventualities, have worthwhile discussions with loved ones, and not miss opportunities to do whatever is important to them with their remaining time. There are patients who may not welcome such openness, but most do appreciate knowing what lies ahead. Learning how to impart such information in a sensitive and compassionate manner requires not only good intentions, but strong communication skills (that we now know can be taught) and the discipline to do what will serve the patient best, rather than what is easiest or feels good.” (“Compassionate Honesty” 2010)
6.“How bad news is discussed can affect the patient's comprehension of information, satisfaction with medical care, level of hopefulness, and subsequent psychological adjustment.” - (“SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer” 2000)
7. “Dealing with conflict is a critical skill for physicians. Recognizing and dealing with conflict can improve relationships, shed light on complicated clinical situations, and help guide family members, patients, and other clinicians through difficult decisions. The reward for physicians who acquire and use these skills are also evident: a grateful family and a personal sense of satisfaction.” - (Dealing with conflict in caring for the seriously ill: ‘it was just out of the question’, 2005)
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