Thursday, 29 September 2011

Communicating Prognosis and Risk, is there a Right Way?

Predicting and communicating prognosis in palliative care -- Glare 343 -- bmj.com
The author of this editorial, published in a recent British Medical Journal writes about the difficulty of communicating prognosis in patients with terminal cancer. This article made me think of my specialty - Cardiac Surgery. Why? Well, many cardiovascular conditions, if untreated, have prognoses that are worse than those of many malignancies. Knowledge of the prognosis of the untreated condition is useful for me as I can put the risk of the treatment, a heart operation in context. This is the way I communicate the risk/benefit ratio of the operation - I tell the patient that it is far more likely that he/she is alive and well in 2,3,4 or 5 years time if they undergo surgery than if they don't.  It is only a few who actually ask me for actual percentages of dying or suffering a serious complication. A clear and unambiguous message I think - isn't it?