A study in the Journal of Clinical Oncology reports via Reuters Health today that cancer patients rarely tell anyone about the problems with the care they receive. The most common problems? Really not too different from what most seriously ill patients interacting with the healthcare system would gripe about, I imagine. “Delays in treatment, surgical complications and other issues related to medical care, in addition to communication barriers or breakdown between them and their doctors” are among the most prominent issues.
So is there something wrong with cancer care, specifically, or just health care, in general? My guess is that there’s a little bit of both going on here. Yes, of course, we are all very aware of the problems in our healthcare system and they include the issues listed above. But cancer care specifically deals with a unique population of both healthcare providers and patients. Patients are trying to be optimistic, forward-looking, and grateful for everything they have, including their doctors. As the author of the study put it, “Sometimes there’s a situation where they’re really still thankful for the care that they got, and so they don’t want to hurt anybody by saying, ‘Everything was great, except…’ Or they don’t want to do harm to their relationship with their doctor.” But this isn’t doing oncologists any favors. Knowing what isn’t working in a system of providing care or knowing when something went wrong is key to ensuring it doesn’t continue to happen.
So what can we do to empower cancer patients to feel free to speak up about dissatisfaction with care without their fearing they will jeopardize the crucial relationship they have with their doctor? First, doctors should be aware that sometimes things, both within and outside of their control, don’t go according to plan. Oncologists coordinate a huge amount of care among many specialists, testing facilities and their patients and their families. That complex of a scenario is bound to have a few goofs. Second, doctors create an environment where patients can speak up. A simple “So is everything going okay with your care? Is there anything that I could do better or do to help?” might go a long way to allowing patients to open up without fear.
So as with many things in life it comes down to good communication and for patients battling cancer that may be even more important than we knew.
Summer Johnson McGee, PhD