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Communicating Medical Risk to Patients
By Thomas J. Bryant, ARM
President, Physicians Insurance
I can’t think of any form of patient-physician communication more important — and difficult — to clearly communicate than the conveyance of medical risk.
A linchpin of shared decision-making and evidence-based medicine, risk communication is considered the key for informed patients’ decisions for medical treatment.
Furthermore, clearly understanding the risks leads to not only greater levels of informed choice for patients but is also associated with greater satisfaction with the process of care and, most crucially, improved adherence to treatment, researchers agree.
Yet it continues to be a minefield for many, especially when a failure to communicate risk leads to the threat — or reality — of a malpractice lawsuit. In Medscape’s 2019 Malpractice Report surveying 4,300 physicians in 29 specialties, specialists reported a significantly higher level of lawsuits than primary care physicians. Of the physicians surveyed, 71% of the doctors named the top reason for being sued is that “patients blame bad outcomes on physicians because they don’t understand medical risks.”
So why is creating a shared understanding with patients so difficult and perilous? And how can you protect your patients and your practice from the negative consequences of poor risk communication?
New research suggests some specific strategies may help physicians more effectively communicate risk and likewise improve patients’ understanding of risks.
Earlier this month, JAMA researchers outlined five important practices that are most likely to “foster presence and meaningful connection with patients” during clinical encounters:
1. Prepare with intention. Take time to familiarize yourself with the patient before starting the visit.
2. Listen intently and completely. Sit and lean forward as you listen to the patient. Don’t interrupt.
3. Agree on what matters most. Seek out what the patient cares about most and make these things priorities during the visit.
4. Connect with the patient’s story. Ask patients about life circumstances; give genuine praise for efforts in specific areas.
5. Explore emotional cues. Be alert for verbal and nonverbal cues from the patient and validate the patient’s emotions.
(NEJM Journal Watch, “5 Practices to Help Improve the Physician–Patient Connection.” January, 8, 2020.)
The study is clear that a physician’s so-called bedside manner is crucial to how well information about medical risks will be absorbed and understood by a patient.
This is borne out by physicians’ real-life experiences. Nearly half of the physicians in the 2019 Medscape survey said they, too, were convinced that better communication with patients would help avert future malpractice lawsuits.
published February 2020
Physicians Insurance President Thomas J. Bryant, ARM, is a licensed Property, Casualty, Life, Accident, and Health broker in all six New England states and has been an adjunct clinical assistant professor in the School of Health Sciences at Bryant University since 2016. Most recently Tom developed a video presentation on malpractice basics for Harvard Medical School’s fourth-year students, and has participated in NEJM Resident 360 virtual panels on topics related to financial matters important to early-career physicians.
Is it time to examine your current policy? What you don’t know can hurt you. For more information on how Physicians Insurance can support your practice and help you mitigate risk, visit www.piam.com or call 800.522.7426.
