Conflicting Goals Influence Physicians' Expressed Beliefs to Patients and Colleagues

Area of Science:

• Medical Communication
• Clinical Decision-Making
• Patient-Physician Relationship

Background:

• Physicians face a challenge in communicating prognostic beliefs to patients.
• Balancing candor with goals like preserving hope and motivating treatment adherence is crucial.

Purpose of the Study:

• To investigate discrepancies between physicians' personal prognostic beliefs and those expressed to patients.
• To understand the reasons behind these communication differences.

Main Methods:

• An online survey of 398 US internal medicine specialists.
• Physicians reported their diagnostic and prognostic assessments for a case.
• They also reported beliefs expressed to patients and colleagues, and reasons for differences.

Main Results:

• Most physicians expressed different beliefs to patients/colleagues than their own.
• Optimism and uncertainty in expressed beliefs increased with poorer prognoses.
• Key reasons for divergence included preserving hope and acknowledging uncertainty.

Conclusions:

• Physicians adjust their communication, expressing greater optimism and uncertainty than their own beliefs.
• This adjustment is particularly evident when discussing poor prognoses with patients.
• The findings highlight the complex interplay of candor, hope, and uncertainty in medical communication.