Patients need clinicians to understand their true preferences for cancer treatment. However, finding out these preferences is a complex challenge, and even the most well-meaning clinicians often miss the mark, according to Peter A. Ubel, MD, Duke-Margolis Center for Health Policy at Duke University, where he is the Madge and Dennis T. McLawhorn University Professor of Business, Public Policy, and Medicine. At the NCCN 21st Annual Conference, Dr. Ubel, a physician and behavioral scientist, used the setting of early-stage prostate cancer to describe the nuances of this endeavor.
“There are clinical situations where you want to engage the patient in decision-making, and the right choice often depends on what the patient cares about. Find out what that is, and you will help the patient get the right treatment,” he said.
However, this is easier said than done, Dr. Ubel acknowledged. In a study led by Angie Fagerlin, PhD, Chair of the Department of Population Health Sciences at the University of Utah School of Medicine, Dr. Ubel audiotaped real physician–patient encounters and found that physicians often make treatment recommendations without understanding the patient well enough for these to be “preference-relevant.”
“Our research shows there are some real problems in achieving shared decision-making,” he said.