Comments on: Your doctor says you have six months to live. Should you believe him? http://healthcare-economist.com/2008/07/23/your-doctor-says-you-have-six-months-to-live-should-you-believe-him/ Tue, 22 May 2012 08:04:55 +0000 hourly 1 http://wordpress.org/?v=3.3.2 By: Hosting the Cavalcade of Risk « The Sentinel Effect http://healthcare-economist.com/2008/07/23/your-doctor-says-you-have-six-months-to-live-should-you-believe-him/comment-page-1/#comment-708 Hosting the Cavalcade of Risk « The Sentinel Effect Mon, 28 Jul 2008 20:55:57 +0000 http://healthcare-economist.com/?p=1016#comment-708 [...] Shafrin presents Your doctor says you have six months to live. Should you believe him? posted at Healthcare Economist, saying, “If your doctors says you only have six months to [...] [...] Shafrin presents Your doctor says you have six months to live. Should you believe him? posted at Healthcare Economist, saying, “If your doctors says you only have six months to [...]

]]> By: Barry Carol http://healthcare-economist.com/2008/07/23/your-doctor-says-you-have-six-months-to-live-should-you-believe-him/comment-page-1/#comment-707 Barry Carol Mon, 28 Jul 2008 00:50:58 +0000 http://healthcare-economist.com/?p=1016#comment-707 I can think of a more pragmatic reason why doctors may systematically overestimate survival time. Namely, it’s gentler. To tell a patient he/she has, say, 3 to 6 months to live when he really thinks its closer to a month sends the message that the end is approaching but it’s probably not imminent. If the prognosis is six months or less, the patient still qualifies for hospice care if that’s what is desired. In my father’s case, when his nephrologists reached the point where he had to say there was nothing more he could do and my father asked him to “lay it on the line,” the prognosis was 3 to 6 months. It turned out to be three weeks. There is no real penalty for the doctor if survival time is overestimated, but, on balance, it’s gentler on the patient and the family to do so. Since this is not a very precise science anyway, for the most part, it seems like a sensible approach to me. I can think of a more pragmatic reason why doctors may systematically overestimate survival time. Namely, it’s gentler. To tell a patient he/she has, say, 3 to 6 months to live when he really thinks its closer to a month sends the message that the end is approaching but it’s probably not imminent. If the prognosis is six months or less, the patient still qualifies for hospice care if that’s what is desired.

In my father’s case, when his nephrologists reached the point where he had to say there was nothing more he could do and my father asked him to “lay it on the line,” the prognosis was 3 to 6 months. It turned out to be three weeks. There is no real penalty for the doctor if survival time is overestimated, but, on balance, it’s gentler on the patient and the family to do so. Since this is not a very precise science anyway, for the most part, it seems like a sensible approach to me.

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