From screen to clinic: How medical dramas shape patient expectations
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Death has been such a taboo topic; I’m afraid that people hold back their questions and concerns as a result.
—Stephanie Harman, MD
Viewers of the TV medical drama The Pitt sought out and shared information on organ donation and end-of-life care after watching episodes with related storylines.[]
How can physicians prepare for these difficult conversations with patients?
“End-of-life discussions are best started by developing an understanding of what matters to patients and how they picture their quality of life. Tools like Five Wishes, designed to help patients identify what is most important to them regarding medical treatment and other priorities, can help clarify these goals and values in a compassionate way,” Brintha Vasagar, MD, a family medicine physician, tells MDLinx.
“When it comes to sensitive topics like end-of-life planning, having a family physician patients truly trust makes all the difference in these emotionally challenging discussions,” Dr. Vasagar adds.
Related: Docs love this medical TV drama—and it might actually be making their jobs easierDiscussions around end-of-life care
More than a third of viewers of The Pitt sought out information about end-of-life care after watching episodes of the show featuring end-of-life storylines.[]
Stephanie Harman, MD, a clinical professor of medicine and palliative care physician at Stanford University, says patients could have many questions about the end of their lives after watching television shows.
“Patients may ask, ‘Gosh, I don’t want that to happen to me,’ or ‘I don’t want my kids to have to be in that position when I’m older. How do I ensure that the medical care I receive lines up with what I want at the end of my life? Or how do I complete an advance directive or advance care planning? Where can I get that?’” she says.
“Respond with encouragement and gratitude for raising hard topics and share resources for patients exploring those topics. And expect emotion. Death has been such a taboo topic; I’m afraid that people hold back their questions and concerns as a result,” Dr. Harman adds.
Common questions physicians may face
A report on viewers of The Pitt found that compared to nonviewers, those who watched storylines about organ donation or end-of-life care had greater intentions to make end-of-life plans or discuss preferences with loved ones. []
Experts say this can often spark a discussion with physicians.
“Common questions often center on control over what will happen, being a burden on family, and reassurance. Patients may ask how to make sure their wishes are respected if they can’t speak for themselves, how to avoid suffering at the end of life, or how to protect their family from having to make agonizing decisions without guidance,” Carter Neugarten, MD, a clinical associate professor of medicine at Stanford University and an expert in palliative care and emergency medicine, tells MDlinx.
“I’d encourage physicians to respond with openness, transparency, and genuine curiosity. These questions usually come from a place of fear, love, or a desire to protect others, so the first step is to acknowledge how hard it can be to raise them. Being clear and honest about what medicine can and cannot do—without being overly blunt or dismissive—helps build trust,” Dr. Neugarten adds.
The realities of end-of-life care
While having open conversations with patients is crucial, says Timothy Schmitt, MD, Director of Transplantation at The University of Kansas Health System, some patients may be surprised to learn that end-of-life care and organ donation are different from how they are portrayed on TV.
“Anything that makes people seek knowledge about transplant or organ donation is great, but what we can’t control is whether, when they seek knowledge … they remain open-minded to what we tell them is the real process and procedure,” Dr. Schmitt adds.