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To patients facing a major operation or medical procedure, it can be a simple, effective aid — a Richter scale for risks that helps patients sort out their treatment options. For providers, it could be a way to reduce exposure to medical malpractice claims.
Created by risk communication consultant and former Oxford University professor John Paling, it was originally developed to help his clients put environmental worries such as weapons storage and chemical emissions in perspective.
Paling says that after his chart was featured in 1995 in Scientific American, physicians convinced him of its potential in medicine.
"The scale’s greatest benefit may be as a visual aid for doctors to use during counseling and informed-consent interviews with patients," he says. "It can help physicians communicate better with patients and reduce misunderstandings that can lead to patient dissatisfaction and malpractice claims."
With the Paling Risk Perspective Scale, doctors can easily display the odds of different treatment options, helping patients compare the risks of each. Absolute certainty, a 1-in-1 occurrence, is on the far right end and the odds decrease by factors of 10 as you move left, or down the scale. Patients understand the scale as easily as a pie or bar chart, says Kenneth Kellner, MD, professor of obstetrics and gynecology at the University of Florida College of Medicine.
"The risk scale certainly enhances the legal informed-consent process," Kellner says. "That should take a back seat, though, to its use as an educational tool to help patients and their families evaluate the risks of therapy, essentially without adding any extra time to the examination."
Though Paling’s instrument is copyrighted, it is available to the public. Digital copies are available at www.healthcarespeaker.com, or by calling (352) 377-2142. Health care providers only need to register as a user to be granted permission to use the scale and reproduce it in their institution at no charge.