Doctors Don’t Follow Their Own Advice

Doctors are hypocrites? No, you’re kidding me! I don’t believe it!

Well, according to a study it’s true. When choosing their own treatment, doctors often do something different to what they tell their patients. Sometimes, very different.

For example, a doctor would not choose an option he or she knew could be fatal—even though he or she was quite happy to recommend that course to a patient! Doctors, it would seem, would rather be paralyzed or in some way disadvantaged than dead. Fair enough. But why don’t they take the same line with a patient?

All this came to light form a study published in the April 11 issue of the Archives of Internal Medicine.

“It’s a pretty clear message: There’s a discrepancy between what doctors recommend to their patients and to themselves,” said Dr. Timothy Quill, author of an accompanying editorial in the journal.

In the study, Dr. Peter A. Ubel, a physician and behavioral scientist at Duke University ,and his colleagues presented one of two different treatment-decision scenarios to primary care physicians in the United States.

For the first scenario, 242 doctors were told that either they or a patient had just been diagnosed with colon cancer and could choose one of two surgeries. Both options had a cure rate of 80%, but one had a higher death rate and fewer side effects. The other had a lower death rate but patients were more likely to need a colostomy or to have chronic diarrhea, intermittent bowel obstruction or wound infection.

When it came to their own bodies and lives, 37.8% of physicians chose the option with higher mortality over fewer side effects, but only 24.5% thought that patients should choose this course.

The second scenario involved being infected with a fictitious new strain of avian flu. The flu itself had a 10% death rate and would send 30% of patients to the hospital for an average of one week.

The one treatment would halve the rate of adverse events, but would kill 1% of recipients and cause permanent paralysis in 4%.

Of the nearly 700 doctors completing this survey, 62.9% decided that they personally would endure the flu rather than get this treatment. For their patients, however, only about half (48.5%) recommended foregoing treatment in the event of infection.

I would say hypocrisy is fair comment, wouldn’t you?

SOURCE: April 11, 2011 Archives of Internal Medicine

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