title: Patients' reflections on communication in the second-opinion hematology-oncology consultation.
abstract: OBJECTIVE
  The nature of communication between patients and their second-opinion hematology consultants may be very different in these one-time consultations than for those that are within long-term relationships. This study explored patients' perceptions of their second-opinion hematology-oncology consultation to investigate physician-patient communication in malignant disease at a critical juncture in cancer patients' care and decision-making.
  
  
  METHODS
  In-depth telephone interviews with a subset of 20 patients from a larger study, following their subspecialty hematology consultations.
  
  
  RESULTS
  Most patients wanted to contribute to the consultation agenda, but were unable to do so. Patients sought expert and honest advice delivered with empathy, though most did not expect the consultant to directly address their emotions. They wanted the physician to apply his/her knowledge to the specifics of their individual cases, and were disappointed and distrustful when physicians cited only general prognostic statistics. In contrast, physicians' consideration of the unique elements of patients' cases, and demonstrations of empathy and respect made patients' feel positively about the encounter, regardless of the prognosis.
  
  
  CONCLUSIONS
  Patients provided concrete recommendations for physician and patient behaviors to enhance the consultation.
  
  
  CONCLUSIONS
  Consideration of these recommendations may result in more effective communication and increased patient satisfaction with medical visits.
authors.affiliation: Warren Alpert Medical School of Brown University, Department of Family Medicine, Providence, RI, USA. roberta_goldman@mhri.org
authors.forename: Roberta E
authors.initials: RE
authors.lastname: Goldman
authors.forename: Amy
authors.initials: A
authors.lastname: Sullivan
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Back
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Alexander
authors.forename: Robin K
authors.initials: RK
authors.lastname: Matsuyama
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006402:Hematologic Diseases; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011379:Prognosis; D036301:Qualitative Research; D012017:Referral and Consultation; D012938:Social Perception