Can the medium used to present medical information affect patients’ understanding and the decisions they make about their medical care?
Yes, according to a new study in the Journal of Clinical Oncology.
Researchers looked at different methods for presenting information about CPR (cardiopulmonary resuscitation) to advanced cancer patients. One group of patients listened to a verbal description of CPR and its chances of successfully resuscitating patients. The other group heard the same information, accompanied by a short (3-minute) video showing a simulation of a patient receiving CPR and being put on a ventilator.
The results: very different. Less than half as many people wanted CPR for themselves when they also saw the video (20%), compared to those hearing only the narrative (48%). Put another way, more than twice as many people wanted CPR when they hadn’t visually seen how it worked. The patients who saw the video were also better informed about CPR and their decisions. This study was conducted as a randomized controlled trial, the “gold standard” for medical research.
Inquiry about how patients — and people in general — process information and acquire knowledge is a burgeoning field of study, both in medicine and neuroscience. The latter has already demonstrated that individuals tend to process and understand information better when they receive it from more than one medium.
This raises a couple of questions for estate planning and elder law attorneys:
- As part of teaching your clients to be good medical advocates (for themselves or as a health care power of attorney), how might you counsel them about ways to better understand the information presented to them? You could advise them to ask for information in different modalities: they can ask for it in writing as well as just being “told.” Or ask for a verbal explanation if they are only handed a piece of paper. This is important for follow-up instructions at a doctor’s visit or upon hospital discharge, as well as when making treatment decisions.
- Should we bring this approach (ie presenting information in multiple modalities) into the advance care planning process earlier on? Possibly even at the point of clients executing their advance directives?
And then there’s the broader question for your practice: As an attorney in an agency relationship with your clients, you possess a vast amount of complex, specialized knowledge that is guiding your counsel to them. Do you think it would help your clients, or your attorney-client relationship, if clients understood more about what you are advising them? (This is not a rhetorical question.) Could it possibly even change their understanding of your questions and cause them to make different decisions? While clients presumably trust your professional expertise, would it nonetheless make some more comfortable to better understand what you’re creating for them? Would increased knowledge of or comfort level with your plan contribute to their willingness to pay a higher fee? To refer others to you?
If the answer to any of these is “yes,” what different, reasonably-priced media could you use to share information that you aren’t using now? If you are principally talking to clients presently, would it be helpful to have a written description also? What about pictures or diagrams — of the A/B Trust design of an RLT, for instance? (I know that those of you in the Academy have the latter already.)
Do you think anything works better than just talking with clients to help convey information and understanding? If so, what? I’d love to hear your thoughts. (And you don’t have to divulge your proprietary info.)
Randi J. Siegel,MBA, is the President of DocuBank(docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the International Society of Advance Care Planning, she is active in health policy and health education related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.
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