Susan Eggly, Ph.D. receives Kales Award for research on patient-doctor communication

Susan Eggly, Ph.D., professor and a member of the Population Studies and Disparities Research Program at the Barbara Ann Karmanos Cancer Institute and Wayne State University (WSU) School of Medicine has been selected as the winner of the Anthony and Joyce Danielski Kales Endowed Faculty Award for Innovative Cancer Researcher for her research into communication between black cancer patients and their medical oncologists.

Dr. Eggly said she is very honored to receive the award, which she said was unexpected.

“The award is so meaningful. As a behavioral scientist and a communication researcher, I feel that this kind of work is tremendously important and that the Kales have shown respect for research in the fields of communication and linguistics that examine patient experience,” she said. “It’s important for our research to improve the lives of patients with cancer and it is a show of respect for the patient experience.”

The Kales Award was created in 2012 at the WSU School of Medicine to recognize exemplary and innovative cancer research. It is supported by the Drs. Anthony and Joyce Danielski Kales Endowed Faculty Award for Innovative Cancer Research Endowment. Selection is based on a comprehensive review of published articles within the previous year.

Dr. Eggly has been cited specifically for a research article that she, her colleagues and lead author Ellen Barton, Ph.D., professor and leader of the Linguistics Program at WSU recently published in the journal Patient Education and Counseling. The article is titled, “The influence of a question prompt list on patient-oncologist information exchange in an African-American population.” It can be found here.

The study, which is among the first of its kind, examined the ways a question prompt list influenced patient-oncologist information exchanges during oncology interactions with black patients. It is one of many publications that came out of a larger project completed by Population Studies and Disparities Program researchers in which they provided patients with a communication tool and then examined video recordings of clinical interactions between patients and oncologists at Karmanos and Henry Ford Hospital.

“The purpose of this study was to empower black patients in the patient-doctor relationship,” Eggly said. The question prompt list created for this specific population – black patients with breast, lung and colorectal cancers, was to designed to encourage them to “let doctors know about their thoughts and feelings, and what information they want. It is an attempt to reduce or eliminate disparities. This is the kind of intervention we can do that will actually make a difference,” she added.

Dr. Eggly states that is a well-established fact that many black individuals mistrust the medical establishment, where most medical oncologists are not black. At the same time, doctors have implicit racial biases against black people, she added.

“We know that the communication process (during) clinical interactions differs between white patients and black patients,” Dr. Eggly said. “From the physician’s side, they have implicit biases. We all do. Physicians have negative biases against black patients and may believe that black patients may not want or need (medical) information,” she said. “From the patient’s side, they often don’t ask questions.”

Many black patients feel “the doctor isn’t trustworthy so they hesitate to ask questions. These patient and oncologist attitudes result in less information exchanged in terms of questions and information provided,” she said. “This may ultimately affect patient treatment and survivorship.”

As a way to promote productive information exchange, Drs. Eggly and Barton and other members of the Population Studies and Disparities Research Program developed a list of 43 questions that black patients may want to ask about their cancer diagnosis, treatment path, treatment side effects, quality of life issues and other questions pertinent to treatment.

The question list was developed over a year and a half, with input from black patients, family members, oncologists, other medical professionals and community members. It was created specifically for cancer patients who already received a diagnosis and had returned to the clinic to talk to their oncologists about chemotherapy treatment.

In the published study involving a secondary analysis of the video recorded interactions, researchers viewed the interactions between 114 black patients and 17 medical oncologists that participated in the study.

They found that the top three questions the patients asked medical oncologists have to do with duration of treatment, side effects and foods that should be avoided or consumed.

A dual purpose of developing the question prompt list was to not only help black patients ask questions but to encourage doctors to be more forthcoming with valuable information for black patients.

“Our goal is for patients and physicians to understand each other and exchange information in the process of making a decision in the treatment for that patient,” Dr. Eggly said. “The purpose of the question prompt list is to get patients to assert their questions and needs and for the doctors to provide information.”

Dr. Eggly has developed roughly 15 different question prompt lists for various clinical settings involving medical oncologists and cancer patients of different races. Right now, she and her colleagues are studying the effects of a question prompt list on black and white patients with prostate cancer who may be eligible for a clinical trial. The team is also looking at the effects of question prompt lists on how patients pose questions about ‘financial toxicity’ (i.e. the negative financial consequences of cancer treatment) and discussing results of genomic and genetic tests.

Dr. Eggly said that question prompt lists, as evidenced by results of the study cited for the Kales Award, influenced the information exchange process by encouraging patients and their companions to prompt their doctor for information, resulting in more of a dialogue than a monologue. Given these results, Dr. Eggly recommends that patients prepare for their doctor visits by thinking about what questions are important to them, getting input from family members and writing questions down before the doctor visit.

Dr. Eggly, who received a master’s degree in linguistics and a doctorate in communication science, both from WSU, said she feels lucky to be working at Karmanos and conducting research that affects people’s lives and reduces health disparities.

“I strongly believe that the way we communicate with each other and the words we use affect our relationships and the world we construct,” she said. “By studying those words and individuals’ motivations for using those words, we can affect relationships and have better relationships. There’s no greater importance than that than in the health care setting.”

Dr. Eggly will be honored at Karmanos' Grand Rounds ceremony on November 5 in a virtual setting. She will speak about her research, specifically the publication for which she is being recognized.