Feature Story

May 21, 2008

ICU physicians less likely to discuss prognoses with African-American patients

From EurekAlert! - Breaking News:

An important study raises concern about the way intensive care physicians approach patients and families facing serious end-of-life medical decisions.

Based on interviews with more than 1,200 ICU physicians at five major medical centers across the country, researchers conclude that physicians are less comfortable discussing end-of-life issues and do it less frequently with African-American patients and their families than with Caucasian patients and families.

J. Daryl Thornton, M.D., M.P.H., of the Center for Reducing Health Disparities at MetroHealth Medical Center in Cleveland and Case Western Reserve University (CWRU), an assistant professor at CWRU, will present the findings at the American Thoracic Society's 2008 International Conference in Toronto on Wednesday, May 21.

"That is why it is so important that physicians are comfortable delivering difficult and sometimes complex diagnoses, potential outcomes and prognoses to patients and families in the ICU," said Dr. Thornton.

"Our study suggests there may be some underlying biases and/or discomfort among physicians, which impacts their ability to have these difficult conversations with families."

These two studies, taken together, suggest we need to collect more information about what impacts the prognostic decisions by physicians, and whether any underlying biases are influencing the way they communicate with patients and families."

On the third day of the study, physicians were asked if they had had prognostic conversations with their patients or their patients' surrogates (the person appointed by the patient to make their medical decisions).

The findings should be replicated and would be an important area for health disparities research---understanding the effects of physician biases on decision-making, communication and patient outcomes in the ICU," said Dr. Thornton.

Read more from this post.