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Patients don’t warm to change with cold hard facts

Dr. Anqi Teng
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Dr. Anqi Teng
Patients don’t warm to change with cold hard facts
Artwork by Ina Jardan and Louise Pau

If the most exciting experience a medical student could have is in the surgical theatres watching entire sections of the lung being removed from a chest cavity, general practice observation would be among the dullest. We anticipated nothing more than coughs and aches while we watched the same consultation on repeat from our little corner. We were mostly right. That’s the point of general practice, after all, to stop a scratchy throat from becoming a hospital admission.


Whilst hospital doctors had an excellent grasp of prognostic data (like knowing that 70% of people diagnosed with Creutzfeldt-Jakob disease die in the first year), general practitioners are experts at preventative medicine and public health statistics. I was interrogated every sit-in session with a tirade of these questions: what’s the most common cancer for non-smoking females under 30? (Melanoma) What percentage of hepatitis B patients develop hepatitis D? (5 %) What’s the most likely diagnosis for the middle-aged lady who came in with heel pain? (plantar fasciitis)


This expertise is a part of why GPs are so positively perceived in the community as health information authorities – they are the most popular human source of health information for lay people. But I have watched these statistics thrown at the patient, who nods and frowns in focus, only to have smokers return still smoking, and diabetics return needing a higher dose of insulin within my five-week GP rotation. Ineffective communication does nothing to prevent risk factors from turning into disease, and with ineffective strategies at the medical frontlines, the hospital battlefield further plunges into disarray to win a war against understaffing, limited resources, and high public healthcare costs.

The answer to this problem is stupidly obvious: the public’s approach to health has never been fully rational.

If health professionals feel like patients don’t care enough about the cold, hard facts – it’s probably true. Beyond the illness, healthcare is about pain, fear, joy, anxiety, hope, loss, and desperation. Few patients think about their body mass index when they’re offered a cold beer by their mate while watching the footy. And smoking is rarely motivated by a desire to increase one’s chances of lung cancer, but rather is the thing that takes the edge off a bad week. To motivate an emotion-driven behaviour, emotional approaches can be more effective in positive behaviour change.


Take smoking campaigns, for example. Emotionally evocative advertisements promote smoking cessation more than evidence-driven advertisements. It seems, on cursory glance, that emotional communication on health topics is always the better option.


But like all things, over-generalisations are generally unhelpful, because there is definitely a time and place for taking a rational approach. Research shows that pre-existing knowledge on a topic will create a preference for qualitative data on that subject, so using data can be more effective for getting through to a healthcare professional. However, level of expertise is not the only thing that impacts this preference. It has been shown that young people in their 20s respond to emotional appeals when it comes to enjoyable consumables like beer, whilst they prefer a rational approach for health-related information. On the other hand, elderly consumers prefer an emotional approach, likely due to a shift towards perceiving emotions as more meaning with age.


Although we are still just learning about which specific groups prefer rational or emotional communication, one thing is clear: only sharing data and statistics with patients cannot be considered effective communication.

For doctors, statistical communication is our baseline. In medical school, we were given isolated lectures about how to communicate in an effective manner to patients. Still, in the hospital space, many doctors forget to make that switch in their day-to-day.  


My favourite GP Dr. Marshall didn’t back this up with statistics, but I believe him nonetheless: “Don’t worry about telling your patient the precise chances of heart failure after finding out they have hypertension. Time is better spent easing them in about not using salt on their dinner from now on.”