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This timely guide to communication in patient-centered medicine
argues for greater clarity in explaining health risks versus
benefits of an array of screening tests, procedures, and drug
regimens. It reviews the growing trend toward patients' involvement
in their own care, particularly in terms of chronic conditions, and
details approaches physicians can use to prepare patients (and
themselves) for collaborative decision-making based on informed
choices and clear, meaningful knowledge. Chapters apply this lens
to a wide range of common interventions as contentious as estrogen
replacement therapy and antibiotics, and as widely prescribed as
the daily aspirin and the annual physical. With this goal in mind,
the authors also introduce an innovative decision-making tool that
translates risks and benefits into a clear graphic format for fewer
chances of miscommunication or misunderstanding. Among the topics
covered: Involving the patient in decision making. Towards a
universal decision aid. BRCT: the Benefit/Risk Characterization
Theater. Breast Cancer Screening-Mammograms. Prostate Cancer
Screening. Colon cancer screening with colonoscopy. Screening for
and treating dementia. Statins, cholesterol, and coronary heart
disease. Physicians in family and internal medicine will find
Interpreting Health Benefits and Risks: A Practical Guide to
Facilitate Doctor- Patient Communication a valuable resource for
communicating with patients and new possibilities for working
toward their better health and health education. This book
considers several common and important situations where faulty
decision-making makes overtreatment a serious risk. Clear, fair,
referenced, and useful information is provided. And a powerful
intuitive technique is introduced which allows patient and doctor
to talk as equals as they work together in the exam room. The
authors emphasize that some patients who have been fully educated
will still accept high risks of harm for a small chance of avoiding
premature death. But as this book is accepted and its ideas and
technique are extended, I feel sure that net harm to patients will
be curtailed. And what is more, the integrity of the
decision-making process will be improved. -Thomas Finucane, MD,
Professor of Medicine, Division of Gerontology and Geriatric
Medicine, The Johns Hopkins University School of Medicine
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