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Jan232011

Questions for your doctor?

Revised July 25, 2008 (en français)

This prompt sheet is intended to stimulate questions that you should write down and ask your doctor or other health care provider. It is based on the SCOPED model of decision making. If you wish to use any of this material as part of any organizational offering, please use the contact sheet to request permission.

Questions for Your Doctor? (SCOPED prompt sheet for patients)

Jeff Belkora, PhD – Director of Decision Services, UCSF Breast Care Center – July 25, 2008

Situation (Key facts and knowledge gaps) Questions about key facts? Diagnosis? Test reports? Pathology report? Anything unusual about your situation for your doctor to know?

Choices (Available actions) Tests? Treatment options? Active monitoring (no further treatment)? Newest treatments? Most proven treatments? Most aggressive treatments? Least aggressive? Middle ground treatments? Second opinions? Clinical trials? Complementary therapies? Remedies for side effects? What to stop doing? What to start? Decisions to make now? Decisions to make later? Past decisions to revisit?

Objectives (Goals and concerns) Goals for doctor’s appointment? Goals for treatment? Preferences about length and quality of life? Regarding quality of life: what to continue/protect? (e.g. relationships, work, hobbies, daily activities, body image, sexuality, child-rearing, etc.)? What to avoid? Preferences about timing, frequency, duration, intensity, location, costs of treatment? Concerns about interactions with other treatments or medical conditions? Hopes? Fears? Unspoken thoughts or feelings? Prefer survival/recurrence/complication rates to be explained in numbers (e.g. 60% ten-year survival rate) or words (e.g. more likely than not to survive)?

People (Roles and responsibilities) Decision-making: Whom do you want to have a voice in influencing your decisions (i.e., seek their input)? A vote (involve them in arriving at a final decision)? Visibility (keep them informed)? Specific preference for your doctor’s involvement (e.g. give information, make a recommendation, make decision for you?) Roles and responsibilities of other people (e.g. other doctors, people accompanying you to appointments)? Who else do you need to talk to? Anyone to exclude? Questions about where else to go for advice or information or support?

Evaluation (Impact of choices on objectives) Questions about how specific choices might affect specific objectives? Baseline prognosis (prognosis with no further treatment)? How choices will affect survival, recurrence, complications, side effects (e.g. rates for patients like you?) How choices will affect longer-term quality of life? Best-case scenario, worst case, most likely (e.g. in terms of survival, quality of life) for each choice?

Decisions (Best choice and next steps.) Which choice best accomplishes the objectives? Who needs to do what, when, where, why, how? What resources can help overcome any barriers to next steps? If undecided/unready: Timeline/deadline for arriving at a decision? Priority relative to other commitments? Resources for addressing information gaps?

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