Impact on Patient-Doctor Relationships
In order to get to know more about the individual’s body and the way it may respond to diseases and medicines, it is often necessary to do some tests. This has several implications.
First of all, patients will become more involved in the decision-making process about their own treatment plan, beginning with a decision on a diagnostic test. A blood test is usually not regarded as inconvenient, but the results may not tell the whole story, while a biopsy, only obtainable under anaesthesia, will probably reveal the underlying problems, but could take several weeks to be analysed.
The patient and the doctor will have to discuss the options and consequences. What might happen if no treatment is administered, while waiting for the test results? What might happen if the medicine is prescribed without determining if it is suitable for the person in question?
Secondly, the patients will take part in the discussion about various therapeutic options. If any predictions can be made about the response to treatment, it will probably be expressed in a success rate. A patient’s interpretation of "chance" is a rather subjective. Some patients will think a 10% chance to respond well to the treatment is a fair chance, while others will not find it worth the discomfort or pain.
The patient will have to be supplied with information about the available personalised treatment options. Therefore, doctors will also have to know what is available and be capable of explaining things clearly to the patient. The doctor’s expertise to analyse test results and put them in perspective, will also be crucial. As has been pointed out by experts, part of the responsibility to improve health literacy lies within the health systems.1
On the other hand, the patient will surely search the internet, looking for a "patient like him or her", and participate in forums. Patients will be more empowered, better informed and more capable of making choices based on detailed information on their patient profile, in other words: they will be more "health literate". Moreover, it is to be expected that in the future patients will be able to find the results of clinical trials on the internet, with exact descriptions of the patient profiles based on biomarkers. Individual patients will be able to make a weighted and personal decision on their participation in clinical trials.
Finally, there is increasing availability of home tests which can be used to determine a person’s biological disposition to a wide range of diseases including cancer. It is important to raise awareness about the fact that the presence of a biomarker for cancer does not necessarily mean that you will get cancer. If patients are concerned about the results of such tests, they should always consult a doctor.