My good friend Dr. Joyce Barrett, who wrote the book "Pregnancy and Birth:
The Best Evidence" with me, paid a lot of attention to this issue. She is
retired now, but was a family doctor who specialized in pregnancy, birth,
and baby care. I remember that one thing she did was tell people "Remember,
I could be wrong." She even joked about getting a sign with those words to
post in her office. Some patients would be just shocked to hear those words
from a doctor!

She recognized that, as a doctor, she could probably persuade most of her
patients to do almost anything, so she went out of her way not to do that.
She would talk to people about the research and why she made a particular
recommendation, and then would try to give them the "other side" as well,
encouraging them to make a choice based on their own situation, needs and
values. In the book, for example, we have a story about a mother who had
very fast labours who chose to have labour induced because she was afraid of
having her baby all alone at their farm. While Joyce generally was reluctant
to do inductions, she helped this mother make a choice that was good for her
and her situation.

When a topic came up, she would often ask people "what do you think?" or
"how would you like to handle this?" Again, people were often shocked. She
asked it in a calm, confident way that I think got across the idea that she
wanted to be their partner in health care - that she would work with them,
not on them.

Jennifer, I think that the fact  you even consider these issues makes a huge
difference to the people who come to you for medical care.

Teresa Pitman
Guelph, Ontario

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