Cardiometabolic Chronicle

Patient Perspective – Denial? Or Doctorly Deference?

Recently, the British Medical Journal (BMJ) ran a compelling opinion piece1 from Boston physician Dr. Abraar Karan on why some patients just don’t seem to understand what their doctors are telling them. Here’s how he opens his essay:

“‘Why am I here?’ Mrs. S looked up at me for the first time since I had entered the room and begun speaking to her. I had spent the past five minutes talking about the need for her to start new medications for her heart failure. She had nodded along for most of the conversation, but I wondered if she had heard, or more importantly understood, anything I had been saying. She had had three admissions for worsening heart failure in the past few months. And yet she looked at me and said, ‘Do I have heart problems? No one ever told me!’”.

  1. Karan, Abrar. “Making sure patients understand and that doctors do too.” The British Medical Journal Opinion, May 23, 2019. Available at https://blogs., accessed August 1, 2019.
  2. Karan, Abraar, and Geeta Sodhi, eds. “Protecting the health of the poor: social movements in the south.” Zed Books Ltd., 2015.
  3. National Network Libraries of Medicine. “Health literacy – definition.” Available at initiatives/topics/health-literacy, accessed August 1, 2019.
  4. Lin, Andrew H., et al. “Repeat hospitalizations predict mortality in patients with heart failure.” Military Medicine 182.9-10 (2017): e1932-e1937.
  5. O’Leary, Kevin J., et al. “Hospitalized patients’ understanding of their plan of care.” Mayo Clinic Proceedings. 85.1 (2010): 47-52.


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