Treat Me Like a Statistic but Please Be Nice to Me
Most patients would be horrified if their doctor said that s/he planned to treat them like a statistic. This might be due to a wish on the part of the patient to believe that there is something specific about them that makes them less sick than the best statistical evidence would suggest they are. If this is the reason, then the doctor is in a real pickle; s/he must try to give the best possible advice to someone who fundamentally doesn’t want to hear it. But the horror might just come from a fear that a doctor who regards them as a statistic denies their basic humanity, which is something that people don’t like even if it has no effect on their health. Of course this need not be the case; it is perfectly possible for a doctor to base treatment recommendations almost entirely on statistical information and at the same time to have the utmost respect for the patient’s irreducible dignity and individuality. It would help a lot if doctors were better at conveying this distinction, and making people feel like they are individually valued even when the medical advice comes straight from the cookie-cutter. Furthermore, patients might not always be wrong in thinking that a doctor who wants to treat them like a statistic really does devalue their humanity; doctors who are sophisticated enough to understand evidence-based medicine need to be on guard against the temptation to use it as an shield behind which to hide any contempt for their patients that they might happen to have. The imperative that medical advice should be based on sound statistical evidence doesn’t make basic niceness any less important. Heads should be hard, hearts should be soft.
I wholeheartedly agree that compassionate care and practicing evidence- (and statistics-) based medicine are not mutually exclusive. Both are essential elements in delivering effective health care. As far as doctors learning more statistics, hopefully this is something that will come with time and humility. I am a medical student and I have blogged on this subject before:http://gopalcamp.blogspot.c...
CheersGopal
It also isn't as simple to treat an indvidual patient as a statistic as you would think at first blush
For fifty years people have been designing protocols that do better than physicians. It's basically trivial, a lot easier than I expected, at first blush. Getting physicians to follow the protocols is the hard part. The problem is that it would dehumanize the physicians, and they, unlike the patients, have the power to stop their dehumanization.
Yes, Michael Sullivan, we shouldn't just shove statistics at doctors. They don't even understand false positives. But the problem of what they should do is solved.