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Education May Help Improve Surgeon-Patient Discussions

Researchers urge educational efforts to improve quality of informed decision-making

WEDNESDAY, Sept. 10 (HealthDay News) -- During office visits in which orthopedic surgeons and patients discuss surgery, opportunities exist to improve informed decision-making, but informed decision-making can be accomplished in a time-efficient manner, according to an article published in the September issue of the Journal of Bone & Surgery Surgery.

Clarence Braddock III, M.D., of the Stanford University School of Medicine in Stanford, Calif., and colleagues recruited 89 surgeons and 133 patients aged 60 to 96, and analyzed audiotapes of 141 discussions about surgery, including knee and hip replacement as well as wrist/hand, shoulder and arthroscopic surgery.

The researchers found that a majority of the surgeons discussed the nature of the decision (92 percent), alternatives (62 percent) and risks and benefits (59 percent), but that they seldom discussed the patient's role (14 percent) or assessed the patient's understanding (12 percent). The investigators also found that the average scores on the informed decision-making-18 metric (which assesses whether or not there was complete discussion of each informed-decision-making element) averaged 5.9 on a scale of 0 to 15. Although the visits only lasted a median of 16 minutes, the researchers found that visit duration only had a modest relationship to the extent of informed decision-making.

"Educational efforts to provide clinicians with knowledge about the informed-decision-making model could have a huge impact on the quality of decision-making," the authors conclude. "Enhancing informed decision-making in this way may reap the benefits of increasing patient satisfaction and improving quality of care. The translation of ethical theory into real-world practice that we have explored in this study can be a model for exploration of best practices in other realms of patient-physician interaction, in surgery and beyond."

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