Arrogance, condescension and indifference in communication with patients

Glòria Galvez

In traditional society, men have had an authority role and women a secondary and subordinate role. As a result of this form of behaviour comes the term mansplaining, a combination of the words man and explaining. The term appears for the first time in a text by Rebecca Solnit “Men explain things to me” to define the habit of some men to express their opinion with authority, condescension and a paternalistic tone on all kinds of subjects, even if their experience is little or non existent.

John Launer, in the article published in the Postgraduate Medical Journal, talks about medical condescension or "docsplaining" that, like mansplaining, has to do with paternalistic and condescending behaviour. In this case, it’s the professionals –men and women– who, to maintain control of the conversation with patients, address them with a certain arrogance exercised from parental ambiguity.

Could the cancer numbers be better explained?

Cristina Roure explained in a post in her blog series "Pantone", an experience that Gerd Gigerenzer, Director of the Max Planck Institute for Human Development in Berlin, wrote in the book "How to know when numbers deceive you", where more than half of the surveyed gynaecologists did not estimate, after seeing published scientific data, what was the probability to have cancer of an asymptomatic woman’s with a positive screening mammogram. In fact the error of most of the colleagues was monumental: they said it was 90% when in fact it was 10%.

In a recent post, I commented on the book of Peter Ubel "Critical Decisions", in which the author showed what the emotional force of numbers was, both for patients and for the doctors. In this certainly worrying line, I want to give you a shred of hope. There are ways to show the numbers in order to reduce the reigning confusion. Many experts are warning us to flee percentages, the ineffable pies and the relative risks, and we have to get used to talking to patients of real numbers, pictograms with people and absolute risks. To make myself understood, I include a couple of graphics from the Harding Center for Risk Literacy, a centre which is in the orbit of Gigerenzer and Max Planck. The first is a pictogram on the evaluation of prevention programs for prostate cancer based on PSA controls and anal touch of the gland.