Cancer Patients Rarely Demand Unnecessary Treatment, Tests
(HealthDay News) — Cancer patients rarely request unnecessary tests or treatments, according to a study published online February 12 in JAMA Oncology.
Researchers surveyed 34 oncologists, 11 oncology fellows, and 15 nurse practitioners immediately after visits with cancer patients at three Philadelphia hospitals between October 2013 and June 2014. Only 440 of the 5,050 visits (about 9%) included patient requests for tests or treatments. Of those, health care providers complied with 365 of the clinically appropriate requests. In addition, there were 50 demands for unnecessary tests or treatments, and health care providers complied with only seven of those demands.
About half of the patient requests (49.1%) were for medical imaging tests, 13.6% were for laboratory tests, and 5.2% were for genetic tests or chemosensitivity tests. More than 1% of patient requests were for palliative care treatments such as pain and sleep medicines (15.5%), 3.6% of patient requests were for chemotherapy, and 0.7% of requests were for costly proton beam therapy. Patients most likely to demand or request tests or treatments included those who had poor relationships with their health care providers and those on active therapy.
The findings show that doctors "have to stop blaming patients for being demanding. In reality, it is hardly happening," Anthony Back, MD, of the Seattle Cancer Care Alliance, writes in an accompanying editorial. "The myth of the demanding patient is more about our own responses and how lackluster communication skills can contribute to difficult situations that stick in our throats and in our memories. And when we have calmed down enough to look up, we see that what is really happening between patients and physicians these days is something quite different."