title: Missed opportunities to counsel patients with malignant pleural mesothelioma about causation and potential compensation.
abstract: BACKGROUND
  Malignant pleural mesothelioma (MPM) is a lethal malignancy strongly associated with occupational exposure to asbestos. The aims of this study were to assess the quality of counseling provided to patients with MPM about the causation of MPM and the potential for compensation.
  
  
  METHODS
  The authors conducted a structured retrospective chart review of patients with a diagnosis of MPM. They abstracted demographic data, occupational and environmental history and exposure data. They also searched for documentation of patient education and counseling.
  
  
  RESULTS
  The authors identified 16 patients with a new diagnosis of MPM during the study period. A job title was documented at least once in the records of 12 (75%) patients. Documentation of occupational exposure to asbestos was found in the records of 12 (75%) patients. Two patients (13%) were presumed to have had bystander exposure to asbestos. Education about MPM causation and counseling about opportunities for compensation were documented in the record of 1 patient (6%).
  
  
  CONCLUSIONS
  Among patients with MPM, documentation of some elements of an occupational history, including an occupational asbestos exposure history, was common. Advice to pursue compensation for potential occupation related MPM was rare. Physicians may be missing opportunities to provide beneficial information to patients with newly diagnosed MPM regarding potential legal redress and compensation.
authors.affiliation: Pulmonary Section, U.S. Department of Veterans Affairs Palo Alto Health Care System, California 94304, USA. kuschner@stanford.edu
authors.forename: Ware G
authors.initials: WG
authors.lastname: Kuschner
authors.forename: Radhika
authors.initials: R
authors.lastname: Varma
authors.forename: Roberto
authors.initials: R
authors.lastname: Flores
authors.forename: Madhuri
authors.initials: M
authors.lastname: Agrawal
authors.forename: Sebnem
authors.initials: S
authors.lastname: Guvenc-Tuncturk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000009:adverse effects; D035881:Compensation and Redress; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000209:etiology*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D010997:Pleural Neoplasms / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D001194:Asbestos