The use of percentages when talking to patients: some advice for doctors.

Doctor_patient_family

Unfortunately, over the past few months I have had occasion to visit many friends and family members both in Intensive-Care Units in hospitals and at home recuperating from their medical intervention. While my experience recently has been in Spain, I have observed exactly the same behaviour is many other countries.

It appears that many patients in hospital often become much less Auditive (focussed on data such as clinical results, etc.) which makes it much more difficult to process on the cognitive logical level – for them!.

While Doctors tend to try and avoid “Emotional empathy(suffering the same “distress” as the patient) and maintain an attitude of “Logical empathy” (where they understand the patient’s situation, fears, hopes, etc) but are NOT affected. This apparent lack of any empathy with/for the patient often works against them with both with the patient and the family members, etc., where they are perceived as “Cold, Distant &/or uncaring / heartless” Realistically, Doctors have to have “logical” empathy or it would often be impossible to provide the care or treatment the patient actually needs however, this perception of the Doctor can have unexpected NEGATIVE consequences – especially if things go wrong!

Doctors, in general, tend to work on data from a range of different sources and frequently tend to provide information in the form of percentages or other “logical” forms;
An example of this would be: “There is an 80% possibility of success (without defining “success”) and 20% possibility of death or deterioration”. This option is often perceived as being much worse by the patient because they appear to only be considered as part of a statistical group and NOT as an individual person whose fate / life is in the balance. Also, the sequence of the options provided is a way to influence, on a subconscious level, how the information is mentally processed. Thebest technique to use is called “The Double Bind” and states that when 2 options are given, the last option is usually chosen/remembered WHEN there is NO specific preference for either of the two “options” given.

From my own personal experience and from many ex-patients that I have spoken to regarding this topic, it appears that most people would often prefer a more open and non-specific range to be given: “A high possibility of X and a lower possibility of Y”. This kinaesthetic version allows the person to create their own mental ratios of the options presented based on how they feel physically and mentally. However, if the patient then asks for the specific odds for each event, they should be given – with the “good news” being given after the bad!

I beliee that it is the duty of every doctor to use the most appropriate persuasive strategies to help the patiends and/or family members to make the “best” decisions possible. This includes a sensitivity to the language and structures used to achieve the desired outcome.

I hope this article has provided some interesting ideas for you.
All constructive feedback would be appreciated.

Ian Brownlee
Madrid, Spain, 21st March, 2019.

Sources:

W.Levinson, A. Kao, A. Kuby, R. A. Thisted: Not All Patients Want to Participate in Decision Making – A National Study of Public Preferences

Strull WM, Lo B, Charles B. Do patients want to participate in medical decision-making? JAMA. 1984;252: 2990–4.

Guadagnoli E, Ward P. Patient participation in decision-making. Soc Sci Med. 1998;47: 329–39.

FOR MORE REFERENCES, FEEL FREE TO CONTACT ME.

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About ianbrownlee

Ian Brownlee, the founder of Brownlee & Associates has been actively involved in the field of interpersonal & transcultural communication since 1977. He has worked in universities and companies in the following countries: Laos, Thailand, Hong Kong, Korea, Japan, Singapore, Saudi Arabia, France, Italy, England, The United States of America & Spain, as a teacher, university lecturer, trainer, researcher & consultant. In addition, his experience in living in these countries, and studying the language & communication and interaction styles of each has aided him in reaching a real understanding of intercultural and transcultural differences and how to resolve them. Ian Brownlee has various masters degrees from British Universities: One in Linguistics & Teaching English Overseas from Manchester University, one in Training & Development with a specialization in the area of Communication and Adult learning awarded by the University of Sheffield. He has also gained professional qualifications in Psychotherapy & Hypnotherapy from various professional organizations. During his university career he has also studied elements of Sociology, Organizational psychology, Educational psychology, Psycholinguistics and Kinesics. He is a licensed Practitioner, Master Practitioner, and Master Trainer in NLP. as well as being a trainer in Ericksonian Hypnosis. He is a member of a wide range of professional organizations involved in Training, Applied Psychology, Hypnotherapy & Ericksonian Hypnosis, Psychotherapy, Interpersonal Communication & Cross-cultural Communication. He is also recognized by the Program on Negotiation, Harvard University, as a Negotiation Skills Trainer & Mediator and has been a collaborator on various projects with the program, and as such is in great demand as a negotiation consultant for some of the largest multinationals operating worldwide. His wide experience gained in multinational organizations in positions such as Director of Training, Communications Consultant and Negotiator / Mediator has helped many people to learn and apply new methods of negotiating skills and advanced communication techniques both in their private and professional lives. He has published various articles & books related to the field of interpersonal communication and he is the author of all the courses taught by Brownlee & Associates. He has lived and worked in Spain since 1985, initially as a trainer / Special Assistant in a multinational pharmaceutical company and then as the Training Manager for a multinational company involved in Clinical Analysis & Nuclear Medicine. Brownlee & Associates was formed in 1991 and currently has a small, highly-trained staff. While based in Madrid, courses are given world-wide either in English or Spanish. Brownlee & Associates currently work with leading international companies in the areas of pharmaceuticals , Information systems, luxury products, food & beverages, etc.
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