Notre Dame, Walther Study to Examine Problem of Poor Communication Between Doctor, Patient in Course


SOUTH BEND, Ind., Nov. 11 (AScribe News) — The doctor-patient relationship in cancer treatment will be analyzed from the rarely examined perspective of patient resources and responsibilities in a new collaborative study by the University of Notre Dame and the Indianapolis-based Walther Cancer Institute.p. Dr. Rudolph M. Navari , director of the Walther Cancer Research Center at Notre Dame, and Rev. James K. Foster, C.S.C., M.D ., a medical ethicist in the University’s College of Science, will develop educational interventions and study whether such tools might improve the therapeutic nature of the doctor-patient relationship.p. ‘’The doctor-patient relationship is particularly important in cancer treatment where there is a significant patient mortality and treatments are complex, long in duration, and can have significant toxicity,’’ says Navari.p. While patients and families traditionally have a high level of anxiety and a wide range of expectations, Navari says that increasingly there is inadequate communication between cancer specialists and their patients, particularly regarding treatment options, palliative care issues and complementary medicine.p. According to Navari, doctors seem to prefer not to ask about a patient’s anxiety and distress, fearing that if they do they will open up a Pandora’s box. And patients appear not to express their distress to their physicians, fearing that they will divert the doctor if they speak up about such concerns.p. Instead, they often may seek comfort by turning to various forms of alternative medicine because they believe it is potentially helpful and psychologically supportive.p. A common finding in studies of the doctor-patient relationship suggests that communication is more effective if patients are better informed of their condition, treatment options, and goals of individual therapies.p. ‘’A better understanding of what cancer patients want and need – and how their physicians can help them – is an important part of cancer research, especially now that new therapies are allowing patients to live longer,’’ says Jim Ruckle, executive vice president of the Walther Cancer Institute.p. Navari adds: ‘’It is often acknowledged that communication between doctors and patients is not good, so many have tried to train doctors to communicate better. But if patients aren’t listening, then no amount of communication is going to help. We will look at ways to refocus the responsibility of communication on the patient.‘’p. Navari and Foster will initiate their study by developing educational materials, including audiovisual tapes, to help patients better understand their conditions.p. The Walther Cancer Institute-Notre Dame collaboration also will develop curricula for medical students, residents and practicing physicians that focus on ethical decisions, truth telling, confidentiality, decision making, informed consent and informed refusal, end of life care, spirituality in health care, clinical research trials and ethical issues related to chronic disease and disability.p. Recent studies suggest that effective doctor-patient communications are an essential ingredient of cancer care, says Navari, because they create good interpersonal relationships, permit exchange of information, and foster beneficial behaviors in patients.p. ’’It’s clear that improved doctor-patient communications should result in improved cancer patient care with a pursuit of realistic treatment goals, improved use of resources, improved end of life care, and avoidance of ineffective, costly and potentially toxic interventions,’’ he says.p. Navari is a practicing oncologist, most recently with the Simon-Williamson Clinic in Birmingham, Ala., until leaving for a fellowship in 1998 at the MacLean Center for Clinical Medical Ethics at the University of Chicago School of Medicine. He joined the University of Notre Dame faculty this fall to direct the Walther Cancer Research Center at Notre Dame.p. Father Foster is an assistant professional specialist who teaches clinical medical ethics and advises undergraduate students in the preprofessional (premedical) studies program at Notre Dame.p. Since it was founded in 1985, Walther Cancer Institute has contributed more than $33 million to collaborative cancer research projects at Indiana University, Purdue, Notre Dame, Michigan and other major Midwest universities and medical centers. The institute dedicates 100 percent of every donated dollar to basic, clinical and behavioral cancer research.

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