A clash between a patient’s assumptions and a doctor’s advice can cause conflicting feelings, influence satisfaction ratings, and affect adherence to a health plan. A better understanding of common misconceptions might contribute to improved strategies for conveying counterintuitive information that improve comfort and well-being (1).

Recognition and acknowledgement of the verbal and nonverbal indicators of common misconceptions and psychological distress could help identify opportunities for improved mental and social health, contributing to better health overall.

One study suggested that people with greater symptom intensity and magnitude of limitations are more likely to be confused by a surgeon’s advice (1). There may be opportunities for additional touch points using web-based materials, decision aids, phone calls, and virtual visits (in addition to in-person visits) that give people more opportunities and more time to identify and correct common misconceptions.  

Evidence has shown that certain nonverbal indicators, such as hand movements intended to limit finger, hand, or wrist pain are associated with unhelpful protectiveness from less effective cognitive coping strategies, such as catastrophic thinking and fear of movement (2).

Less effective coping strategies slow recovery and can limit the final result. Clinicians can  address catastrophic thinking with patience, empathy, and compassion. Formal support in the form of cognitive-behavioral therapy and related techniques is supported by evidence, but not readily available and not always appealing to patients. There are workbooks and apps as alternatives. Frontline clinicians can also learn the techniques of cognitive behavioral therapy and incorporate them into their care.

References

1. Strooker JA, Nota SP, Hageman MG, Ring DC. Patients with greater symptom intensity and more disability are more likely to be surprised by a hand surgeon’s advice. Clin Orthop Relat Res. 2015 Apr;473(4):1478-83. doi:10.1007/s11999-014-3971-5. Epub 2014 Oct 4. PubMed PMID: 25280552; PubMed Central PMCID: PMC4353519.
2. Wilkens SC, Lans J, Bargon CA, Ring D, Chen NC. Hand Posturing Is a Nonverbal Indicator of Catastrophic Thinking for Finger, Hand, or Wrist Injury. Clin Orthop Relat Res. 2018 Feb 14. doi: 10.1007/s11999.0000000000000089. [Epub ahead of print] PubMed PMID: 29480887.