Issue link: https://beckershealthcare.uberflip.com/i/1149353
15 PATIENT EXPERIENCE Viewpoint: Patients have the right to not know their prognosis By Anne-Marie Kommers I t is important that terminally ill patients be able to choose whether they are informed of their prognosis, BJ Miller, MD, a hospice and palliative care specialist at the University of California San Francisco, and Shoshana Berger, an editorial director at Ideo, wrote in an op-ed for e New York Times. Patients facing serious illness feel empow- ered when they make decisions about the flow of information, Dr. Miller and Ms. Berger wrote. Furthermore, prognoses are oen inaccurate. ey are based on the average life spans of previous patients with the same disease, and physicians tend to overestimate life expectancy, particularly for patients they like. Choosing not to know information can be countercultural in an age obsessed with data, Dr. Miller and Ms. Berger wrote, but the choice can be liberating. e authors cited Steve Scheier, founder and CEO of Deci- sion Clarity Group, who designed a form called the "Prognosis Declaration" aer his wife died of cancer in 2010. e form gives patients various options to help them decide how much they want to know about their illness, ranging from, "Tell me everything," to "I don't want to receive any information on my prognosis." While the form may not become standard practice, Dr. Miller and Ms. Berger wrote it is an effective way to help patients think through the kind of care they want to receive. Such decisions should lie in patients' hands, not physicians'. n Hospitals with fewer services receive more 5-star patient experience ratings By Mackenzie Bean P atients are more likely to give five-star rat- ings for patient experience to hospitals that offer fewer services, according to a study published in JAMA Internal Medicine. For the study, researchers examined CMS' 2014 patient experience ratings for 2,798 hos- pitals nationwide. Of these hospitals, 150 received a five-star rating. These hospitals were 84 to 92 percent less likely to offer emergency services, intensive care, cardi- ology or neurology, reported Reuters. These findings suggest that patients should not solely rely on five-star ratings when deciding where to seek care. "This is especially true for patients with multi- ple medical problems and chronic illness. They are much less likely to receive comprehensive services when admitted," Zishan Siddiqui, MD, lead study author and researcher at Johns Hopkins School of Medicine in Baltimore, told Reuters. "Hospital patient experience rating systems in general should be just one of many hospital metrics patients should look at when selecting hospitals." n Viewpoint: 4 vaccine misconceptions physicians should address with patients By Anne-Marie Kommers P hysicians have a responsibility to provide patients with a solid foundation of information on vaccines, Amitha Kalaichandran, MD, a resident physician of pediatrics at Children's Hospital of Eastern Ontario, wrote in an op-ed for the Los Angeles Times. She outlined four vaccine misconceptions providers should address with patients: 1. Physicians must explain how vaccines work. Dr. Kalaichandran cited a father who viewed vaccines as medicine for sick children and questioned why his healthy child would need a vaccine. After she explained that vaccines are actually tools to prevent future ailments, the father agreed to vaccinate his child. 2. Autism diagnoses often occur around the same age that children receive vaccinations, said Dr. Kalaichandran. Yet timing is not enough to draw causal relationships; there must also be a rational reason to connect one occurrence to another. Physicians should explain that rigorous research has shown no connection between autism and vaccines, said Dr. Kalaichandran. 3. People are poor judges of risk, said Dr. Kalaichandran. They may tend to fear rare vaccination side effects over vaccine-preventable conditions, even though they are at a far greater risk for the latter. 4. Vaccines only represent a small portion of pharmaceutical prof- its. Therefore, it is incorrect for patients to assume that vaccines are only promoted for large profits, Dr. Kalaichandran said. n