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Stuart Schneller

| Oct 11, 2015 6:34 pm

As a clinical rheum for 35 yrs I try to compare risk with a context they know. I tell them they know that driving In a car to today's visit entailed a risk. Accidents occur some even resulting in death. But walking here is not practical so taking the small recognized risk was for them acceptable. Then I explain things that are done to mitigate risk. Drive a safe car at the speed limit. Wear seat belts. Avoid dangerous drivers. Drive when alert. Monitor your car and your own status. You wouldn't drive with a blindfold on!! Then I describe all we do to monitor them while they are on the treatment. Visits to ask questions and exam them. Pre-rx tests. Blood tests to detect problems while they are reversible. Use least necessary dose. I say you wouldn't drive your car around for no reason. Why take that risk? They are being given this therapy for a sound reason and it is worth taking the real but small risk. I wouldn't expect them to leave their car and walk home today. Then I suggest they discuss the treatment plan w/ family and come back to make a decision. It doesn't work for all patients but it does give a familiar risk context without satistical gibberish.