What are some practical tips for when a patient's consistently stated goals of care do not correlate with their actions?  

First, it's important to remember that most of us have inconsistent beliefs. We both want to lose weight, and we want to eat chocolate cake; we want to get an A, and we want to go to the party. So when we see inconsistencies in others' beliefs, rather than being judgmental, we should get curious. Ou...

I agree with Drs. @Arnold, @Lustbader, and @Wolfe's astute advice about staying curious. To Dr. Wolfe's point, very few parts of a serious illness are within our patients' control, so it's very common for patients to seek out ways of regaining some autonomy. We expect our patients to give us their b...

When a patient’s actions don’t align with their stated goals, I see it as an invitation to explore. Life is rarely linear, and goals evolve as circumstances change. If something feels “off” about a choice, my first instinct is curiosity: What is the patient hoping for wi...

I agree with Drs. @Arnold and @Lustbader. While this can be very frustrating for providers, I agree that this is an opportunity to get curious.  Things that might be helpful are discussing how tests/PT, etc., are going to help them achieve their stated goals.  I would also explore why th...