Discussing risk factors

Dr C posed a question about when to discuss risk factors with a patient.

Obviously if there are things the patient needs to be warned about it must be done before treatment commences.

Things such as the risk of breakage of a filling, the risk of a tooth going non-vital or the risk of nerve damage with a lower wisdom tooth extraction.

If you warn the patient before you start and a problem occurs then the patient owns the problem. If you don’t warn the patient then you own the problem.

But, when do you give the warning(s)?

There is a psychological phenomenon called “decision paralysis”.

It occurs when a person is swamped with too much information. Basically their brain cannot process all the information. Instead, they become confused and go home to think about it.

Therefore, if you want to make it as easy as possible for the patient to make a decision you need to break up the information that you give them into “bite-sized” chunks.

I recommend first offering the patient the treatment alternatives and getting a decision.

Once they’ve decided you then tell them about the risk factors and check that they are prepared to accept those.

That makes it a two step process but by doing it in this way you keep things simple and avoid overwhelming the patient with too much information.