How to make the best decision in the consulting room
When it comes to healthcare, you might not immediately think of its impact on climate. Yet this can play a role in medical decision-making. Healthcare costs, AI and social media also influence this. How do we ensure that GPs make the best decision for the patient in the consulting room, with as little negative impact on society as possible? Jesse Jansen is researching how decision-making in clinical practice can be supported as effectively as possible.
Jesse Jansen is a researcher at CAPHRI and the Department of Family Medicine, coordinator of the general practice and social medicine clinical rotation, and coordinator of Appropriate Care at the Living Lab Family Medicine in the South-East of the Netherlands. With her background in health and cognitive psychology, she conducts research into medical decision-making. “I look at how patients and healthcare professionals arrive at sound medical decisions in a world full of uncertainty, information, AI, societal expectations and scarcity,” she explains.
Climate
Alongside scientific evidence, many other factors play a role nowadays. “Accessibility, costs and climate are examples of the societal implications of medical decisions,” says Jesse. “The healthcare sector is responsible for around seven per cent of total emissions, so we want to reduce that as much as possible. Those emissions come from the buildings we work in, the electricity they consume, waste from operating theatres, but also certain medicines that negatively affect surface water or air quality. Moreover, climate change also has an impact on health itself, for example through heat stress. My research focuses on whether and how such broader implications play a role in the decisions made on a daily basis in the consulting room.”
Testosterone test
“I’m also interested in how we can ensure that the scarce resources we have are used as effectively as possible. In this regard, it’s important to take crowding-out effects into account. If we provide a lot of care to patients who don’t actually need it, because they haven’t developed any symptoms yet but, for example, see on social media that it’s a good idea to have a testosterone test, then that comes at the expense of care that could be given to patients who really need it. After all, you can only spend the money once. In that case, care that doesn’t contribute much crowds out the care that could actually make a big difference to vulnerable or very ill patients.”
Digital care
Furthermore, Jesse is looking into digital healthcare. “AI also influences decision-making in the consulting room. How do patients interact with AI, and how is that reflected in the decisions made? The same applies to social media. What patients see there affects the questions they ask their GP and the choices that are made as a result.”
GPs are asked all sorts of questions that are almost directly related to what is happening on social media or in society.
Effective communication
Jesse is currently working on several research projects. “One of them focuses on effective communication regarding diagnostics. These days, people have direct access to a lot of medical information and test results in their medical records. That’s great, but we also know from research that this can cause stress and anxiety among patients, because it’s quite difficult to fully understand those results. Together with PhD candidate Frederieke van der Mee, we are therefore investigating how test results can be communicated in such a way that people understand them properly and do not immediately become worried.”
“We’re also looking at how decision-making works in GP practices with patients who have limited health literacy. That’s tricky, also for GPs, because you have to focus particularly on what’s important to the patient and perhaps focus a little less on explaining all the options in detail. It’s quite a complex process, and there’s been very little research into it so far. PhD candidate Laura Vriese is currently working on that.”
Social media
“Developments are happening very quickly: certainly in the field of medicine, with new treatment options and insights, but also in society. It’s quite difficult to keep up with it all, and therefore also to explain it properly to patients and help them weigh up treatments that all have different pros and cons. You see this most clearly in general practice. GPs are asked all sorts of questions that are almost directly related to what is happening on social media or in society. That is a very dynamic environment for making medical decisions. I find it incredibly interesting to support both patients and doctors in this as effectively as possible. Ultimately, my research centres on the question of how we can help patients receive the care that truly adds value for them, and how we can prevent unnecessary care.”
During the CAPHRI Research Day on 10 June, Jesse and Merel Kimman will be leading a workshop in which participants explore how different stakeholders weigh up issues such as climate, effectiveness and costs in medical decision-making. Want to know more? Take a look at the programme.
Text and photo: Joëlle van Wissen
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