Along with diagnosis and treatment is the central issue of prognosis for outcome. The patient seeks to know not only the timeframe but the degree of recovery anticipated. The news media has increasingly addressed dramatic organ transplantation and cosmetic surgical procedures. While the education provided by the media is often intended to be cutting edge technology, it also serves to entrench the public’s perception that diagnosis leads to treatment and, in turn, to resolution of complaints.
Little emphasis is placed in the lay press upon chronicity of complaints, that total joint replacements, spinal fusions or coronary artery bypass grafts do not restore premorbid health, but are a means of dealing with a system now forever compromised.
Many patients anticipate that care will result in complete relief of symptoms, offsetting the need for future concerns, and that activities possible prior to disease or injury will once again be available without limitation.
Addressing these issues with patients includes the following points:
a.What do you anticipate will be the outcome of this procedure?
b.What provisions are you making for any residual limitations?
c.Are you able to construct a life around your remaining abilities, or do you feel life would be unmanageable if you are not able to return to your former level of activity (mobility, etc)?
d.Do you believe that the recommended procedure will leave you with none of your current physical compromises?