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Many Docs Deliver Cancer Diagnosis Badly: Study
Date:7/7/2010

437 patients responded to the written survey.

The more impersonal the setting and the less time spent, the less satisfied patients felt. When treatment options were not discussed, patients were also dissatisfied.

"We need to understand patients, when they feel comfortable when told of a diagnosis, and what are the settings that make them feel comfortable," said study author Dr. William D. Figg, senior investigator at the U.S. National Cancer Institute in Bethesda, Md. "It's better when we can tell them face-to-face when there is a troubling diagnosis because it will better enable them to cope."

Of the 57 percent who changed doctors after the diagnosis, patients gave various reasons including a desire to receive treatment at another facility, participate in experimental trials or get treatment closer to home. But among those who changed, 15 percent said they had lost trust in their physicians, 10 percent blamed poor communication and 12 percent noted general dissatisfaction. Patients were allowed to give more than one reason for changing doctors.

On a scale from zero to 100, the median satisfaction score given by patients in the way they learned of their cancer was 74 percent. Nearly 80 percent reported a greater than a neutral level of trust in their doctor, with 16 percent expressing "absolute trust."

Before the 1970s, doctors often concealed a cancer diagnosis from their patients, according to background information in the study. Disclosure is now routine, but physicians should try to relay the findings in a personal setting and allow time to discuss the diagnosis and means of treatment, the study authors suggest.

The authors say it is sometimes appropriate to relay a cancer diagnosis over the phone, for example, when "results of a final test may confirm a cancer diagnosis" and waiting to schedule an appointment would be undesirable. Doctors also might want to tell a patient in an emergency room when a blood test confirms
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