don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

A relatively new program for educating hospital and other patients about the risks of various medical procedures has proven to be successful. The patient education program, described below, makes me wonder if a similar effort ought to be designed to benefit the tens of millions of non-patients at even greater risk due to unhealthy lifestyles than those going under the knife for little things, like heart transplants and the like. The lifestyle kamikazes will soon enough need surgeries -- for diseases and organ failures associated with smoking, substance abuse, overeating and under-exercising plus all manner of other depravities associated with self-destructive habit patterns. All they have to do is live long enough and, in time, they will be lining up for medical repair jobs -- and watching videos about the risks of the procedures they will undergo.

The new patient health education program, designed to explain surgical procedures and the risks inherent in such treatments (and to protect doctors and hospitals from malpractice suits), is called Expectation Management and Medical Information, or EMMI. About 85,000 patients have been "emmied" during the last two years in advance of undergoing one of over sixty different types of medical procedures. An article about the EMMI experiment appeared in a recent Wall Street Journal ("Managing Expectations for Surgery: New Tools Help Hospitals Explain Procedures, Risks; Protection From Malpractice," December 14, 2005; p. D5). 

The EMMI program involves lectures, consultations, videos, brochures, instructional CD-ROMs and interactive computer simulations of procedures that patients are scheduled to undergo. The information is given at a doctor's office, in a hospital or even at home through an e-mail link to a website. The programs are in use at hundreds of clinics, hospitals and doctor offices. The messages include warnings about possible complications from all manner of factors, including but definitely not limited to anesthesia, post-surgical infections and blood clots. Sometimes the information is conveyed in a cartoon format, though I don't think many patients find the messages all that funny. One person quoted in the WSJ story did manage this upbeat response to the risk message conveyed: "I liked that it wasn't gory."  Yeah, I think I would like that, too, if I were going through an EMMI orientation prior to something like brain surgery. 

A lot of malpractice suits are prompted in part by inadequate communication and attendant unrealistic expectations prior to surgery. Studies clearly show an inverse relationship between patient information prior to undergoing medical procedures and lawsuits. If patients feel informed, they generally don't sue, even if the outcomes are not so good.

Of course, not many folks with dreadful health habits can say they were not warned about their specific behaviors and high-risk lifestyles. Who would claim he/she had no idea it was dangerous to be fat and stressed out, addicted to tobacco and given to sloth? Should doctors offer patients with awful habits wellness lectures, consultations, videos, brochures, instructional CD-ROMs and interactive computer simulations? Should "Expectation Management and Wellness Information" programming or EMWI initiatives be made available not just in doctor offices but in schools, churches, social clubs and everywhere else?

Yes. That's what America needs more than warnings about the risks of surgical procedures. At least I think so. What do YOU think? I'd love to hear from you. 

All of this reminds me of a medical joke making the rounds. Stop me if you've heard it. 

THE JOKE:  Doesn't it seem that more and more physicians are running their
practices like an assembly line? Consider the experience of a guy named Buford. When he entered the doctor's office, the receptionist wrote down his name, address, medical insurance number and told him to have a seat. Fifteen minutes later, a nurse's aid came out and asked Buford what he had. Buford said, "Shingles." So she wrote down his height, weight, a complete medical history and told Buford to wait in the examining room. A half hour later a nurse came in and asked Buford what he had. Buford said, "Shingles." So she gave Buford a blood test, a blood pressure test, an electrocardiogram, told Buford to take off all his clothes and wait for the doctor. Finally the doctor arrived and did a quick glance at Buford's naked body. He said, "Where do you have the shingles?" Buford said, "Outside on the truck. Where do you want them?"

Too bad the doctor's office did not have the EMMI program or, better yet, my suggested EMWI program. 

Be well. l ways look on the bright side of life.

(Note: This essay will be filed in the archives in the MEANING DOMAIN under the skill area of relationships. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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