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- CHICAGO (Reuters) - U.S.
physicians rarely fully inform their patients about the care-giving decisions
affecting them, a survey of more than 1,000 doctor-patient discussions
concluded on Tuesday.
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- Audiotapes of 1,057 patient visits involving 59 primary
care physicians and 65 general and orthopedic surgeons revealed that only
9 percent of 3,552 medical decisions made met the researchers' criteria
of complete informed consent.
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- The criteria for informed decision-making was defined
by researchers at the University of Washington, Seattle, as making the
patient aware of his or her role in the decision, the nature of the treatment,
alternative treatments, the pros and cons of the alternatives, the patient's
understanding of the decision, and the patient's preferences.
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- The physicians were found to be more likely to explain
to patients the nature of the planned medical intervention but were unlikely
to assess the level of patients' understanding.
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- ``There are quality-of-care concerns, since there is
mounting evidence that inadequate patient involvement may interfere with
patient acceptance of treatment and adherence with medical regimens,''
the report's author, Clarence Braddock III, wrote in the Journal of the
American Medical Association.
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- ``This low level of informed decision-making suggests
that physicians' typical practice is out of step with ethical ideals,''
he wrote.
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- According to the report, there have been increasing calls
in the field for more meaningful dialogue between physicians and patients.
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- A shortage of time, especially for primary care physicians,
is part of the problem, Michael Barry of Massachusetts General Hospital
in Boston wrote in an accompanying editorial.
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