Issue link: https://beckershealthcare.uberflip.com/i/1075308
21 PATIENT EXPERIENCE Care decision-makers often overly confident about loved ones' treatment wishes By Megan Knowles S urrogates — or indiviudals responsible for making medical decisions on patients' behalf — are often overly confident in their ability to make treatment decisions in line with a patient's wishes, according to a study published in JAMA Internal Medicine. The study, conducted by researchers at the Yale School of Medicine in New Haven, Conn., assessed surrogates' level of confidence in their knowledge of patients' preferences via interviews with 349 veterans getting primary care in the VA Connecticut Healthcare System. The veterans were asked to choose whether three health states were acceptable to them after treatment: severe physi- cal disability, severe cognitive disability and severe pain. The surrogates were then asked to rate these health states as they thought the patient would and say how confident they felt in making a decision that represents the patient's views. Although 75 percent of surrogates said they felt extremely confident in their ability to make treatment decisions accord- ing to the patient's wishes, only 21 percent of surrogates knew the patients' ratings for all health states. "It's important for clinicians to educate the patient on the need to sit down and talk to a loved one and to refer to ex- isting tools or written materials. The clinician can provide any number of sources of information," study author Terri Fried, MD, told Yale Daily News. "These conversations can't happen in a 20-minute primary care visit — these are in-depth discus- sions and happen at the kitchen table." n Physician viewpoint: We must stop blaming patients for unhealthy lifestyle choices By Mackenzie Bean P hysicians must abandon the mindset that patients who practice unhealthy behaviors, such as smoking, are to blame for their illness- es or cancer, Monica Bhargava, MD, an Oakland, Calif.-based pulmonary and critical care physician, wrote in an op-ed published by The Washington Post. "Our culture's tendency to frame certain illnesses as character defects, as opposed to complex phenom- ena with genetic and psychosocial components, is widespread and carries serious consequences," Dr. Bhargava wrote. She said smokers are "shamed more vocally" for having lung cancer than other patients who de- velop diseases strongly linked to patient behavior or lifestyle. Dr. Bhargava also said she's witnessed how this stigma alters the care pulmonary patients receive at her practice. Physicians have a responsibility to promote healthy behaviors and offer patients help to quit harmful habits, she acknowledged. "But if our patients receive a cancer diagnosis, we need to care for them with a spirit of unconditional empathy and advocacy," Dr. Bhargava concluded. "Our patients are more than what they have ingest- ed or inhaled." n Why Mount Sinai opened a 'man cave' By Mackenzie Bean N ew York City-based Mount Sinai Health System unveiled a "man cave"-themed waiting room at the urology depart- ment's practice in midtown Manhattan to encourage male patients to get screened for prostate cancer. e room is filled with memorabilia from local sports teams, a free coffee bar and educational resources on prostate health. Mount Sinai partnered with the nonprofit Man Cave Health to create the space. Man Cave Health founder Tom Milana Jr. was diagnosed with prostate cancer in 2016. He underwent surgery at Mount Sinai and is now cancer-free. Mr. Milana said the experi- ence inspired him to launch Man Cave Health. "Men need to know that it's important to go to the doctor, and if we can provide them with an environment that is male-friendly, it will encourage them to seek preventive care and treatment," he said in a press release. Mount Sinai is the first health system to launch a man cave, although Mr. Milana told CBS New York he hopes to open another 12 to 15 man caves at hospitals in major cities over the next five years. n