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May 13, 2002

"What Should I Do, Doc?": Some Psychologic Benefits of Physician Recommendations

Arch Intern Med. 2002;162(9):977-980. doi:10.1001/archinte.162.9.977

RECENTLY, I was speaking with an elderly patient about a small prostate cancer discovered by his urologist. The urologist recommended a course of treatment and the patient wondered what I thought about it. I explained that the "correct choice" depended on his views of the trade-off between watchful waiting and early therapy. After I explained the clinical risks and benefits of these 2 strategies, he asked me, "What would you do if you had this cancer?"

"This is your decision to make," I explained. He looked confused. "Let me try an example," I replied. "What are you going to watch on TV tonight?" "The football game," he responded. "Bad decision," I said, "You should watch the figure skating competition on channel 19 instead." He looked at me incredulously. "But I don't like figure skating." "Exactly!" I exclaimed, "I can't tell you what to watch on TV tonight because the ‘right choice' depends on your preferences. The same thing goes for deciding about your prostate cancer." He seemed to understand my point. He looked me in the eyes and said, "Okay, doc. What would you do if you were me?" I recommended watchful waiting and he breathed a sigh of relief.

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