Abstract
Objective
To explore the experiences, approaches, and challenges of physicians consulting patients
about experimental stem cell and regenerative medicine interventions (SCRIs).
Participants and Methods
From August 21, 2018, through July 30, 2019, semistructured interviews of 25 specialists
in cardiology, ophthalmology, orthopedics, pulmonology, and neurology were conducted
and qualitatively analyzed using modified grounded theory.
Results
All specialists used informational approaches to counsel patients, especially orthopedists.
Informational approaches included explaining stem cell science, sharing risks, and
providing principles. Several specialists also used relational counseling approaches
including emphasizing that physicians want what is best for patients, acknowledging
suffering, reassuring continued care, empathizing with patients and families, and
underscoring that patients have the final decision. Many specialists reported being
comfortable with the conversation, although some were less comfortable and several
noted challenges in the consultation including wanting to support a patient’s decision
but worrying about harms from unproven SCRIs, navigating family pressure, and addressing
stem cell hype and unrealistic expectations. Specialists also desired that additional
resources be available for them and patients.
Conclusion
Physicians relied more heavily on providing patients with information about SCRIs
than using relational counseling approaches. Efforts should be directed at helping
physicians address the informational and relational needs of patients, including providing
tools and resources that inform physicians about the unproven SCRI industry, building
skills in empathic communication, and the creation and dissemination of evidence-based
resources to offer patients.
Abbreviations and Acronyms:
CAM (complementary and alternative medicine), SCRI (stem cell and regenerative intervention)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 25, 2021
Footnotes
Potential Competing Interests: Dr Behfar is a cofounder of Rion LLC and owns stock in Sorento Therapeutics, Inc, and Deverra Therapeutics, Inc. Dr. Shane Shapiro is a consultant for Bioventus. The other authors report no competing interests.
Identification
Copyright
© 2021 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
