Bad News and Patient Satisfaction

The New Yorker has an interesting article on how doctors giving bad news, including advising behavior change, decreases patient satisfaction even when it’s in the patient’s best interest.

A recent study examined patient satisfaction among more than fifty thousand patients over a seven-year period, and two findings were notable. The first was that the most satisfied patients incurred the highest costs. The second was that the most satisfied patients had the highest rates of mortality.

This shows up even more in the context of end of life care and terminal illness:

The disconnect between patients’ understanding of disease and their satisfaction with physicians is particularly pronounced for care at the end of life. In a recent study published in the New England Journal of Medicine, oncologists studied patients’ expectations of chemotherapy options. For these patients, with either end-stage colon or lung cancer, chemotherapy may provide some help, but it can also be toxic, and definitely doesn’t provide a cure. Doctors know this, but do patients?

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