at The Risk Communication Institute truly believe
that doctors who interface with patients have the
most difficult job of all the professions. Nevertheless
the fact remains that risk communication is the essence
of informed consent and most doctors find the process
less than satisfactory.
When doctors and genetic counselors are compared to professionals in other industries, it is striking that healthcare stands out as the exception to the norm.
In all other professions where risks have to be explained to the public (e.g. chemical, nuclear, food and drink), it is recognized that it is difficult to do it effectively and so only a few people do the job and they are all highly trained. In contrast, in healthcare (where incidentally the risks are usually far higher and more complex) almost every clinician and genetic counselor actually does discuss risks with patients but few have any training whatsoever!
In addition, there is another area where doctors might learn from professionals in other fields. All media experts who want the public to understand numbers invariably use visual aids such as pie charts and bar charts. In contrast, health care professionals, faced with the same challenge, have rarely sought to use visual aids.
Putting all this together and reinforced by requests from doctors themselves, have lead to several journals, including The British Medical Journal, have produced special editions on the topic of risk communication. John Paling was involved in planning and writing BMJ’s special edition and these articles serve as a good introduction to many aspects of the topic.
A far more complete account of Dr Paling's work is found
in his book Helping Patients Understanding Risks
Good communication and close doctor-patient partnerships
are also are an antidote against being sued for medical malpractice
All research studies confirm that med malpractice claims are far less likely if the patient feels that the doctor is caring as well as competent. using visual aids to support risk communication provides both information about the data and also a social lubricant to help partner with patients.
John Paling speaks at conferences across the country to introduce doctors to his simple but effective ways to help patients understand risks. He brings the lessons from the risk communication courses he has designed for other professions and adapts them to the special needs of healthcare.
The Risk Communication Institute offers unique communication tools that are as easy to understand as pie charts, bar charts and graphs. Paling’s visual aids are deceptively simple but, in practice serve many important functions. First they show the risks in a context that allows the patient to see them in perspective. Also they can display the likelihood of both the positive and negative outcomes at one time (so avoiding the possibility of the patient being disproportionately swayed by hearing only about the negative possibilities).
But perhaps most important of all, these visuals serve as wonderful opportunities the doctor and patient to sit together and discuss the potential risks and benefits in a caring and informative manner. At the same time, the doctor can use this close and focused time together to explain how the patient’s medical team will do all they can to help on the journey.
An early example of
the use of perspective scales was Dr. P. Small's work on putting smallpox
risks into perspective