Information giving and receiving in hematological malignancy consultations.

Area of Science:

• Oncology
• Medical Communication
• Health Disparities

Background:

• Communication in hematologic malignancy consultations is understudied, particularly in tertiary care settings.
• Subspecialty consultations offer unique insights into physician-patient communication dynamics, characterized by length and goal-oriented information exchange.

Purpose of the Study:

• To describe and quantify communication content during subspecialty hematology consultations.
• To identify patient and provider factors associated with specific communication elements in these consultations.

Main Methods:

• Audio-recorded consultations of 236 patients and 40 hematologists were analyzed.
• Communication practices were coded, and multilevel models were used to assess associations between patient, physician, and consultation characteristics and discussion elements.

Main Results:

• Discussions on visit purpose and patient disease knowledge were frequent.
• Patient preferences for decision-making roles, information, and understanding were less common.
• Treatment recommendations were given in 97% of consultations; unambiguous prognosis was presented in 81%, associated with non-White race, lower education, more questions, and specific providers.

Conclusions:

• While some communication behaviors are standard, others, like discussing patient preferences, are infrequent.
• Tailoring information exchange is crucial, as only about half of patients receive clear prognostic estimates.