Explaining cardiac interventions: Using analogies to improve communication


Dr KK Aggarwal    13 October 2017

The doctor-patient relationship is the foundation of practice of medicine. And, communication is the key factor that decides the interaction between the doctor and his/her patient and influences outcomes. Doctors are bound, both ethically and legally, to provide adequate information to the patient so that the patient can participate in the decision making process and are in a position to take an informed decision. Any information given to the patient should be in a language, using words or using terms he/she can understand. But do patients really comprehend the information that is given to them during the process of informed consent? The science of medicine is abound with complex concepts. Medical terminology uses technical words and jargon that are unfamiliar to the patient and difficult to understand. This may hinder the effectiveness of communication. One way to improve communication and enhance understanding of medical information is by using analogies. The dictionary meaning of an analogy is a resemblance between two situations, people or objects that are otherwise unlike, especially when used as a basis for explanation. Analogies are situations that are familiar to the patient and so easily understood. The information is also better retained. Hence, using analogies to explain complex medical terms or concepts can improve doctor-patient communication. This is how I explain cardiac interventions to my patients. I take the example of traffic management, a situation familiar to all. For any traffic management, following are the options: Placing traffic signals can be equated to dos and donts of lifestyle management. Posting a traffic inspector on the crossing. This can be equated with a clinical cardiologist. Diverting the traffic from main road to side roads. This can be equated to opening collaterals by drugs and/or exercise. Hiring an architect to make maps. This can be equated to an angiographer (cardiologist) doing angiography. Looking for the possibility of widening the roads. This can be equated to balloon angioplasty. To prevent encroachment of widened roads to place railings around the widened roads can be equated to placement of metallic stent. To prevent mishandling of railing, safety grills are put. This can be equated to drug-eluting stents. When the roads cannot be widened, flyovers are made, which can be equated to bypass surgery. Flyovers can be made by stopping the traffic. This can be equated to open heart bypass surgery. Flyovers can be made without disturbing the traffic, this can be equated to heart bypass surgery. (Disclaimer: The views expressed in this write up are entirely my own)

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