Patients perceive physicians with optimistic news as more trustworthy and those with less optimistic prognoses as less compassionate, according to a study published last Thursday in JAMA Oncology.
The study was a randomized clinical trial in which 100 patients with advanced cancer were asked to watch two videos of physicians discussing treatment options with an advanced cancer patient. Both physicians said five empathetic statements and used the same posture, but one physician was more optimistic than the other.
Study participants then ranked the two physicians' compassion on a scale of zero to 50, with zero being the most compassionate. The study revealed the following points.
- Patients gave the physician with the optimistic prognosis a median score of 19 on the compassion scale and gave the less optimistic physician a score of 26.
- A greater number of patients (63) said the optimistic physician was trustworthy after watching the videos than the less optimistic physician (39).
- The optimistic physician was preferred by 57 respondents, 22 preferred the less optimistic physician and 21 had no preference.
"Factors that influence the reluctance of physicians to deliver less optimistic messages to patients with advanced cancer include, among others, fear of being blamed, fear of destroying hope or provoking emotional distress and fear of confronting their own emotions and death," according to the authors of the study. "At the same time, improved delivery of treatment and prognostic information would enable patients to make a more informed decision."