Table 5.

Quotations About the Theme: Patient Communication

Participant Number	Indicative Quotation
11	“You give the patient a lot of reassurance when you say to them, a group of doctors have sat down and reviewed this. And then they in turn give me reassurance. So, I think it helps to develop really positive working relationships with the patient. And it can expedite things for patients. So, instead of them having to go sequentially to see different consultants to get opinions we can usually get a combined opinion at the time.”
8	“I think they make a difference in the sense that patients take a lot of comfort in knowing that their case is being discussed in a forum with other specialists and so they know the decisions being made are not just from one individual.”
6	“I think, the only other risk is the patient doesn’t hear second and third opinions directly. They’re getting a consensus view from a group of doctors, so they don’t directly hear the discussed conversation, and the second and third opinions.”
11	“I suppose there’s that fine line between open disclosure and having the patient fully informed. And working to not break the patient’s or medically impact the patients’ confidence in their overall management. If it was a very minor issue and really of no clinical concern … I probably would not discuss it. But if it was a major issue then I would have to discuss that. … But being able to present the different opinions of different people to the patient can sometimes help to clarify things for them.”
13	“I cannot see the point in wasting time [referring every patient] … I do believe that we do overall harm patients by discussing those cases that for which there’s no evidence that discussion benefits.”
5	“No, we do not … sometimes we actually discuss patients before we see them. If I see someone that I am going to discuss, I will tell them that they are going to be discussed. And as long as we have got enough information from either a discharge summary or referral letter and some imaging, normally we can discuss. And then we will tell them afterwards, by the way, we discussed your case at the MDT and this is what was recommended. But we do not have any formal process for consent.”
6	“We have no document … So, we have electronic case records, but we do not have formal consent. Sometimes I write in the notes for MDM, and I have mentioned it to the patient, but it’s not formal consent”