Tell doctors medical stories, and they'll remember more details

Everyone can remember the story of how Cinderella lost her glass slipper.

In the same vein, two Penn professors are investigating whether anecdotes can help doctors remember factual guidelines more easily.

The preliminary results of their study indicate that, indeed, stories embedded with medical guidelines help doctors recall more facts than reading straight guidelines.

Professors Zachary Meisel and Jeanmarie Perrone are studying how doctors adopt medical guidelines, and how their adoption of the guidelines affects prescribing pain medications, such as oxycontin and percocet.

Meisel explained that past research has focused on patients, and how narratives and storytelling influence how often patients use medications. His research aims, instead, to examine how this practice influences physicians’ actions.

“We’re particularly interested in ... how physicians can be more motivated to actually engage in good guidelines [for opioid prescriptions],” Meisel said.

The researchers studied physicians attending a conference in Philadelphia in 2012. At the conference, half of participating physicians were given guidelines in the format they were normally published in — the control condition —, while the other half were given guidelines embedded within a story — the condition being tested.

A few hours later, the Penn researchers administered a free recall test to the conference attendees, where participants were asked to write down everything that they remembered from the information previously given to them.

“What we found was that people who had read the story were basically able to remember virtually every detail of the story,” said Austin Kilaru, a medical student who worked on the study. “They were keyed in on the details, keyed in also on the important parts that we wanted them to remember.”

Kilaru also explained that unlike the participants given guidelines within a story, the control group did not remember as much and fabricated parts of the information they had read as well.

“People were usually able to remember one or two of the recommendations and write those down but they didn’t remember a lot,” Kilaru said. “In addition, one of the most surprising things we found was that people thought they remembered stuff and would write down entirely new guideline recommendations.”

Perrone said the study is relevant to the prescription crisis at large — that doctors are overprescribing strong pain medications for patients who don’t necessarily need them.

Perrone explained that these guidelines were created to give physicians more information about prescribing medicine “safely and judiciously.”

“Twenty years ago when I was in medical school, these medications were reserved for cancer patients and those in severe pain,” she said. “Now you can get significant medications because there is a big push to make sure nobody has pain ever.”

Perrone wants to change the nature of prescribing so that young people cannot easily access strong medications for less-serious conditions.

“There is a growing epidemic of opioid abuse and overdose and unfortunately physicians have something in general to do with this,” Kilaru said. “Opioids are probably the most potent pain medicine that we have and in the interest of balancing offering good pain control for patients and also protecting them and society ... we wanted to improve the adoption of guidelines by physicians.”

Ultimately Kilaru said that they plan to do further experiments to follow up this “preliminary study.”

“We really want to study if narratives or stories can really change physician practice,” he said.

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