Danny Lieberman, founder of Pathcare, the private social network for doctors and patients, talks about optimism bias and why it’s a good thing for doctor-patient relationships.
In March, I went in for my annual physical.
The office at my neighborhood Clalit HMO was a zoo, Dr. Irina had just spend 30′ with an old couple and was running late with a waiting room full of irate patients, crying babies and fazzled moms.
I walked in and gave Dr. Irina a big smile, thinking ”I just want for this person to be happy”.
Sitting there with a med school resident in family medicine, she relaxed immediately and smiled back to me, and turned to the resident and said “You know, Danny only comes in here when he needs a letter for a bike race or his gym, this will be quick and easy”.
Effective doctor-patient communication is a central clinical function in building a therapeutic doctor-patient relationship, which is the heart and art of medicine. This is important in the delivery of high-quality health care. Much patient dissatisfaction and many complaints are due to breakdown in the doctor-patient relationship.
A doctor’s communication and interpersonal skills encompass the ability to gather information in order to facilitate accurate diagnosis, counsel appropriately, give therapeutic instructions, and establish caring relationships with patients.
Patients reporting good communication with their doctor are more likely to be satisfied with their care, and especially to share pertinent information for accurate diagnosis of their problems, follow advice, and adhere to the prescribed treatment. ”Doctor-Patient Communication: A Review” Jennifer Fong Ha et al.
Patients translate good communications in the doctor-patient relationship to higher levels of trust and satisfaction leading to better compliance with the treatment plan and better outcomes.
Doctors benefit from good communications in the doctor-patient relationship to higher quality more timely data, easier decision making and higher levels of success.
“Medicine is an art whose magic and creative ability have long been recognized as residing in the interpersonal aspects of patient-physician relationship.” Communication of affect between patient and physician.Hall JA, Roter DL,Rand CS.
Everyone agrees that good communications is good for the doctor-patient relationship which is good for better compliance and outcomes. Listen to your doctor and do what she says is all there is to it.
But how well good is the doctor-patient relationship once you get past the basic communications skills?
Everyone cannot be an optimist
If you asked the average physician how good his communication skills are, he would probably rank himself as good to excellent – perhaps ranking himself/herself in the top 20% of physicians.
But that is impossible.
It’s impossible for all doctors to be in the top 20% of good communicators in the doctor-patient relationship.
If you asked the average patient how good his communication skills are, he would probably rank himself as good to excellent – perhaps ranking himself/herself in the top 20% of patients in his ability to communicate the right data to his/her physician.
That is also impossible.
It’s impossible for all patients to be in the top 20% of good communicators in the doctor-patient relationship.
Israeli psychologist and neuroscientist Tali Sharot researches “optimism bias.”
She claims that 80% of us experience it. “It” being the tendency to overestimate the likelihood of good things happening to us. As she puts it: “we’re more optimistic than realistic, and we’re oblivious about it.” An example: Divorce rates in the western world weigh in at about 40%. Yet when you ask newlyweds to rate their own likelihood of divorce, they more than likely put the figure at, yes, 0%.
Is optimism bias good for the doctor-patient relationship?
Yes, it is.
Tali Sharot has 2 observations about optimism bias that I think are relevant to the doctor-patient relationship.
- Interpretation matters:Whatever happens, whether you succeed or fail, whether you get better or don’t, people with high expectations always feel better. That’s why optimists who get a discouraging lab test will blame the testing procedure; next time, the results will be better. Pessimists who get a good lab result will be sure that they will fail next time.
- Optimism changes objective reality: Optimism is not the result of a successful treatment plan, it also leads to it. If you expect to do succeed, you will put more effort into making it succeed, do the exercises, take the meds on time and monitor your progress.
So – it doesn’t really matter if you and your physician are not really in the top percentile of great communications in the doctor-patient relationship. It’s enough for the two of you to be biased in the right direction and …. that is a good thing.
- Increase patient confidence
- Give you complete privacy
- Increased compliance
- Better outcomes