“I think people died because of me,” she said. “And I'll spend my whole life trying to make amends.”
In the 1980’s Bastian travelled around Australia and appeared on TV to champion homebirths, until she learned that babies born at home have a higher mortality risk. Now, a movement known as ‘evidence-based medicine,’ delivers tools and techniques by which doctor’s can use facts to change people’s minds and behaviours.
1. Provide the facts in a clear and digestible manner
The first technique is taking the time to explain a belief instead of simply stating the belief and then expanding on why the opponent is wrong. For Bastian, for example, the process of converting from an advocate of home births to a champion of hospital births, took several years during which she conversed with experts who were both compassionate with their worldview and generous with their time.
They explained not only the evidence for and strengths of hospital births but also its limitations. They were critical of weak research and arguments, irrespective of which side it was on and this credibility and trustworthiness helped cement the fact that hospital births are better.
In addition to this, experts have learned that ensuring information is reliable and easy to access can help in the flow of communication with patients. Although doctors often cherry-pick studies or use the same ones they learned in medical school, these can be old or an inaccurate representation of the research.
Having information such as the Cochrane Collaboration – a systematic and coherent summary of the best science on different topics, easily available, can help doctors quickly correct any misconceptions patients might have about important health issues. Patients can also be provided with the ‘plain language summaries’ from studies so they can contexualise and understand research themselves.
2. Reinforce the facts with emotional understanding
Alongside providing appropriate and simplified research, it is also important for doctors to note that just evidence is not enough. As Benjamin Djulbegovic, a cancer researcher and evidence-based medicine thinker at the University of South Florida, explains, “evidence is necessary but not sufficient for decision making or changing behaviors.” Public health experts and those who are trying to change habits such as stopping a patient from smoking, must meet people on their level and understand the reasons for their behaviour.
The forth lesson experts expound is holding misinformation peddlers to account because some people will not be swayed by research or compassion. The widespread circulation of fake health news on social networks is especially dangerous.
In 2016, the most popular article on Facebook with the word ‘cancer’ in its headline spoke about dandelion weed as a cure for cancer. It received more than 1.4 million shares, likes and comments. Ben Goldacre, a professor at the Oxford Center for Evidence-Based Medicine says, "Going after people who facilitate the cranks is more likely to produce long-term benefits and also more closely reflects where the true source for the problem lies.”
3. Create an environment that encourages communication
David Colquhoun, Professor of Pharmacology at University College London believes, “quackery is rampant in areas where conventional medicine can’t do as much as people would wish. Its led people to think there’s a cure for anything, which there’s not.”
It is because of this hope that, through all of this, doctors should remember to be respectful with patients as it is easy to fall victim to medical misinformation that sounds believable and logical. Conversely, patients can become cautious or skeptical if they hear that a commonly practiced medical approach is dangerous.
Remembering that this is not a personal attack can help doctors maintain concern for a patient’s fear. Knowing the doctor cares can help the patient relax, and open the door to an honest conversation. MIMS
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