A study in JAMA found that patient expectations regarding the benefits and harms of any treatment, tests or screenings are vastly unrealistic. In 88 percent of the benefit expectation outcomes studied, authors concluded participants tended to overestimate the benefits of treatment. In 67 percent of the harm expectation outcomes studied, patients vastly underestimated the harm that would result from treatments, tests and screenings, according to the report.  The conclusions were:

The majority of participants overestimated intervention benefit and underestimated harm. Clinicians should discuss accurate and balanced information about intervention benefits and harms with patients, providing the opportunity to develop realistic expectations and make informed decisions.

I agree but the issue is time. Grinding through a 22-25 patient per day schedule will never allow you enough time to document much less speak candidly to patients.  Those expectations may be more unrealistic than patient expectations.  But there is way to do this.  And I am doing it. It is called DPC.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  1 comment for “Overestimating

  1. December 31, 2014 at 8:37 pm

    Now compare that study to what you might get when you study psychiatrists, and this one looks tame. Psychiatrists, as a general rule, believe their meds are wonder drugs with no negative side effects (or at least, none which cannot be treated with yet another drug or changing to a different wonder drug) and no possibility of addiction or misuse.

    Anyone prescribing a drug whose effects they only have learned about from marketing agents is failing as a doctor.

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