Doctors Often Don't Tell Patients About All Risks Of Treatment Options

According to a review published in the week’s PLoS Medicine, doctors in Australia frequently don’t disclose all the possible risks about treatment and procedures to patients.

Although doctors are expected to share information with patients that might affect treatment decisions, including risks of adverse outcomes, David Studdert from the University of Melbourne found that doctors are often uncertain about which clinical risks they should discuss with their patients prior to treatment.

For the study the team analyzed 481 malpractice claims and patient complaints from Australia involving allegations of deficiencies in the process of obtaining informed consent.

Of the 481 cases, 9% were disputed duty cases, meaning that they involved disagreements over whether a particular risk should have been discussed prior to treatment. According to the researchers, the majority of these disputed cases were related to 5 specific outcomes that impacted the quality of life for patients, such as chronic pain and requiring additional surgery. Furthermore, two-thirds of these cases involved surgical procedures.

The team discovered that the most common reasons doctors gave for not informing patients about certain risks prior to treatment were that they believed the specific risk was covered by a more general risk that was discussed or that the risks were too rare to warrant discussion.

Of the cases studied, the team discovered that 9 in 10 involved arguments over who said what, and when.

The researchers explained:

“Documenting consent discussions in the lead-up to surgical procedures is particularly important, as most informed consent claims and complaints involved factual disagreements over the disclosure of operative risks.Our findings suggest that doctors may systematically underestimate the premium patients place on understanding certain risks in advance of treatment.”

They conclude: “Improved understanding of these situations helps to spotlight gaps between what patients want to hear and what doctors perceive patients want – or should want – to hear. It may also be useful information for doctors eager to avoid medico-legal disputes.”

Written by Grace Rattue