“As clinicians, we often end up focusing on something narrow and small that we think we can fix,” Dr. Jha said. “That leads us down the path of surgical intervention. But what the patient cares about is not going to get fixed.”
Dr. Jha provided a recent example from his hospital. A man had metastatic pancreatic cancer and was dying. A month earlier, he had been working and looked fine.
“No one had talked to him about how close he was to death,” Dr. Jha said. “It’s the worst kind of conversation to have.”
Instead, doctors did an endoscopy and a colonoscopy because the man had internal bleeding. Then they did abdominal surgery. “We did all of this because we were trying desperately to find something we could fix,” Dr. Jha said.
The man died of a complication from the surgery.
“The tragedy is what we should have done for him but didn’t,” Dr. Jha said. “We should have given him time to have the conversation he wanted to have with his family. You can’t do that when you are in pain from surgery, groggy from anesthesia. We should have controlled his pain. We should have controlled his nausea.”
Instead, Dr. Jha said, “we sent him to the O.R.”
Source: http://www.nytimes.com/2011/10/06/health/research/06medicare.html
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