Tuesday, June 28, 2016

What do you do when a patient asks to speak to another patient who has undergone cancer surgery?

Not infrequently, I am asked by my patients if they could speak with any other of my patients about their experience of having undergone radical prostatectomy surgery for prostate cancer.  In the past, I have done my best to assist with this request but in more recent years I have moved away from supporting this.  I have a couple of reasons for doing this.

Firstly, it could be argued that selecting patients for such a discussion is like cherry picking. It is arguably little different from a patient testimonial on a website where the most favourable outcomes are provided although unlike the latter, it does not breach AHPRA regulations for advertising.  

Secondly, patients under long term care for cancer treatment are potentially vulnerable.  As doctors, we should never underestimate the desire of patients to please us and the potential for some patients to fear displeasing us by refusal to submit to any request we make of them. 

In writing this, I do not mean to suggest that I am critical of those who provide their own patients as a resource for other patients seeking support or real life experiences. I know that this is done by the vast majority of clinicians with the very best intentions. There may be a time a place for this, particularly with uncommon diseases or unusual clinical circumstances.  

My approach is to now to keep an arms length. I now place my patients in contact with a choice of the local prostate cancer support group or the Prostate Foundation of Australia who are able to provide such a service in addition to their excellent information resources.  From time to time, my patient will be placed in touch with somebody who just happens to also be a patient of mine and that is absolutely fine with me.  I feel comfortable with this transparency and I am also gratified by the positive feedback from my patients who have undertaken this suggested approach.