I'm Going to Mexico

The situation
The patient announces that she will seek alternative therapy for her lymphoma instead of undergoing the recommended chemotherapy.

Communication issues
Patients have a great deal of access to alternative treatment information via the Internet, and some of it may offer promise of non-toxic curative remedies. This may be a significant problem especially when the condition is potentially curable with conventional therapy. I'm going to MexicoOn the other hand, taking conventional therapy may be frightening for some patients, as well as unpleasant and hard to take.

While many cancer patients are interested in various kinds of complementary therapies, a rejection of standard therapy in favor of an alternative can be a very disconcerting announcement for a physician to hear.

This is not a totally uncommon situation in oncology today, but may be a highly-charged and emotive issue. It is very easy for the discussion to become bogged down in misunderstanding or adversarial stances when a patient rejects your recommendations in favor of ones you view as inferior.

What to watch for
Notice that the physician doesn't engage in a discussion about the proposed alternative treatment, but opts instead to explore the reasons for the patient's decision or desire to have unconventional therapy. He thereby discovers feelings, attitudes or experiences with conventional therapy which can be addressed empathically and with additional information. He also offers a compromise, which includes continuity of care, prevents the relationship from becoming adversarial and leaves the door open for future treatment.

View Vignette: I'm Going To Mexico (9:30)
Pearls & Pitfalls: Expert Comment (3:50)


Previous PreviousMy Mother's Not To Be Told Go to Next Page

Free CME Credit Available

Certain material on this site is available for Continuing Medical Education Credit. To obtain credit you must use the “Free CME and RME Credit” link.

Risk Management Education (RME) Credit Available

Certain material on this site is available for Risk Management Education Credit (only for physicians enrolled in the The University of Texas Professional Liability Insurance Plan). 

The RME Credit link is for those who only want to obtain RME.  CME credit is not awarded through this link.

You may obtain both RME and CME credit for viewing the same module by entering through the "Free CME and RME Credit" link.  

Applying for both CME and RME?

If you are applying for both CME and RME for the same module, you MUST view the video through the CME and RME Credit link

NOTE:  RME is only available to physicians enrolled in The University of Texas UT Professional Liability Insurance Plan.