2. Assess What the Patient Wants to Know
Not all patients with the same diagnosis want the same level
of detail in the information offered about their condition or
treatment. Studies have categorized patients on a continuum
of information-seeking behavior, from those who want very
little information to those who want every detail the physician
can offer.30 Thus, physicians should assess whether the patient
desires, or will be able to comprehend, additional information.
For the physician without advance knowledge of the
patient, this level of need will emerge by degrees as the discussion
unfolds and as the physician attempts to synthesize and
present information in a clear and understandable manner.
As when obtaining informed consent, a standard first step in presenting information to a patient would be to describe
the risks and benefits of the procedure and then to simply
allow the patient to decide how much additional information
he or she wants. However, as suggested elsewhere in this section,
this step may require direct questions, strategic silences,
and frequent verification that the information is actually being
comprehended.
One telling sign of whether the patient is understanding
the information is the nature of the questions patients ask; if
questions reflect comprehension of the information just presented,
a further level of detail may be warranted. If questions
reflect confusion, it is advisable that the physician return
to basic information. If the patient has no questions or is obviously
uncomfortable, this is a good opportunity for the physician
to stop the discussion, ask explicitly how much information
the patient desires, and adjust accordingly. Continuing to
provide further information is not always the best approach