A new analysis published in the Annals of Family Medicine,”Primary Care Physicians Use of an Informed Decision-Making Process for Prostate Cancer Screening,” found that 24% of primary care physicians who responded to a survey said they ordered screening without discussing it with patients.
How’s that for shared decision-making?
Fewer than 48% of those surveyed said they discussed harms and benefits with patients before letting the men decide. These doctors “were more likely to endorse beliefs that scientific evidence does not support screening, that patients should be told about the lack of evidence, and that patients have a right to know the limitations of screening; they were also less likely to endorse the belief that there was no need to educate patients because they wanted to be screened.”
(You can see the Reuters Health story on this study here. Was this the only mainstream news organization to report on this study? If so, why? )
Let me remind you of a classic case of a doctor ordering a PSA test without telling a patient. About 15 months ago, I posted a video of lawyer Tim Glynn whose doctor ordered a PSA test without telling him. His anger is still palpable 14 years after this incident. “It drove tremendous consequences for my life on a piece of information that isn’t information – it doesn’t mean anything,” he says in the video.
And let me remind you of the DECISIONS study that found that “most prostate cancer screening decisions did not meet criteria for shared decision making because subjects did not receive balanced discussions of decision consequences, had limited knowledge, and were not routinely asked for their preferences.”
The body of evidence is growing: many American men are not being provided the evidence they need to make an informed decision about prostate cancer screening. And harms may occur as a result.