HMS/HSDM Class Day
2005
The Doctor’s Advice: Talk to Strangers
Faculty Symposium
Profs Tell Tales of Molecular Medicine
HSPH Class Day
UN Official Sees Women’s Health Crisis in Africa
Alumni Day
How Doctors Speak to the Public
Class Symposium
For Class of ’80, Risk and Reward Mark a Productive 25 Years
DMS Symposium
Integration Key to Student Success in Life Sciences
Student Speakers
Students Recount Lessons Learned
Scenes From Alumni Week
Pictures from Commencement and Alumni Week activities
Student and Faculty Awards
Honors Given to Faculty and Students During Commencement
Growth Factor May Aid in Crohn’s Disease Treatment
Bench Science Advances Against Cancer
Dental School Dedicates New Building on Longwood
Faculty Health Survey Being Conducted
Awards Recognize Advancement of Women
BLAST Resource Available to HMS Faculty
The July Effect: How Hospitals Cope with Intern Turnover
ALUMNI DAY
How Doctors Speak to the Public
The medical community has not always won stellar marks for its communication skills, from complaints of rushed visits with harried doctors to questions about drug companies manipulating medical information. Grappling with these issues is unavoidable. “What we do is built around communication with others,” said Daniel Federman, the Carl W. Walter distinguished professor of medicine and senior dean for alumni affairs and clinical teaching at HMS, as he introduced the June 10 HMS Alumni Day Symposium “Communication in Medicine.” The program examined the interface between doctors and the public.
Photo by Steve Gilbert
At the Alumni Day Symposium, Charles Hatem said that doctors have much to learn from patients, but they must first learn to elicit the patient’s voice.
At its most basic level, communication is the interaction between a physician and a patient. Charles Hatem, the Harold Amos professor of medicine at Mt. Auburn Hospital, spoke eloquently about the place of communication in the patient–doctor relationship, using anecdotes about how patience or a thoughtful question could yield important information about a patient. Both he and audience members commented on the frustration over the “pernicious mismatch” between the emphasis on this kind of interaction in medical education and the realities of medical practice.
Jeffrey Drazen, the Parker B. Francis distinguished professor of medicine and editor-in-chief of The New England Journal of Medicine, broadened the focus to address how information from clinical trials is communicated to the medical community and the wider public. He told the story of how COX-2 inhibitors became best-selling and heavily marketed drugs even after preliminary results from clinical trials suggested they might carry cardiovascular risks. “There was a clue that these drugs had a problem,” Drazen said. “But the sponsors selectively filtered what they told the world.” When data were presented in a more complete form, the risks became more apparent.
Photo by Steve Gilbert
Jeffrey Drazen presented a new system for registering clinical trials that he hopes will make the results more open and transparent.
Though the COX-2 story has been widely reported in the media as a sign of inappropriate corporate control of data, Drazen pointed out another oversight—the duty that study sponsors have to the thousands of patients who willingly volunteer to be a part of trials under the assumption that the information gathered from their participation will be used to help people. Without that trust, he said, the continued involvement of volunteers is threatened. “We want this process to be open so that it will continue to go forward.” The journal has joined other leading international medical journals in requiring that all clinical trials it publishes be registered in a public database, ensuring that information from the studies is freely available.
The broadest form of communication is the mass media, and Timothy Johnson, medical editor at ABC and HMS lecturer on medicine, argued that changes in media delivery may affect the relationship between medicine and the public. The expansion of media outlets on cable networks and the Internet is compromising the quality of medical news, he said. “I shudder at what I see going on around me.” The splintering of the mass media has created “a frantic competition to be first,” Johnson added, and medical information that was once carefully controlled by the medical establishment now flows more freely.
He ended his talk by asking the audience, “Who owns medical information? Who has the ultimate right to decide when it should be given to the public?” When he first began his career at Good Morning America in 1975, Johnson said the answer might have been the medical establishment or the government. Now, many would argue that the public has a right to full ownership of all information, whether it has been carefully evaluated or not. One audience member suggested that in this new environment, deciding what the “truth” is in medical information may increasingly be left up to the individual.