Giving patients hope is an important aspect of the doctor-patient relationship that contributes to good outcomes. Early on in my career as a new Endocrinologist, I saw Alice, a 35-year-old woman with Type 1 diabetes and mild diabetic kidney damage. I started her on a protein restricted diet and medication to slow the progression of diabetic kidney disease. Eager to not be missing any other new therapy that might be helpful, I referred her to a kidney specialist. Alice came back to see me two weeks later, and burst into tears as soon as I entered the exam room. Alarmed at her distress, I asked what had happened. Through her tears, she sobbed,
I went to the nephrologist and showed him all the lab results you had done and your recommendations which he advised me to continue. Then he showed me a graph outlining the progression of diabetic kidney disease. He told me, based on your lab values, this is where you are now and in 4.2 years, you will have end-stage kidney failure and need to start on dialysis!
That nephrologist was a fledgling physician, like myself, and he was probably trying to be very scientific in presenting Alice the most precise data. What I learned from that experience was that a physician’s words can be destructive or healing. Giving Alice such cold, hard facts implied her progression to kidney failure was inevitable. In any study, there are always “outliers”, who do better than the average participant. It is important to not give false hope, but patients should be encouraged to defy the odds because the patient’s mental state and perception have a powerful effect on self-healing.
Excerpt from “Outliving Your Ovaries” © 2012 by Marina Johnson MD.
Dr. Johnson has no financial conflicts of interest or ties to any pharmaceutical company.
Her only objective is determining the most effective, safest therapy for patients.