Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (2)

Evidence That Doctors Make Bad Patients?

Physicians recommend treatments with higher survival rates for their patients, but they make more mental mistakes when they are the patient and have to choose for themselves.

Psychologists know that when people make decisions for others, they are dispassionate enough to be less swayed by extraneous factors. Even toddlers make less impulsive decisions for others than they do for themselves.

Researchers surveyed general internists and family medicine specialists about two scenarios, each with two treatment alternatives. Both outcomes involved a choice between surviving a fatal illness but with sometimes crippling outcomes. Physicians were randomized to groups in which they imagined themselves as the patient facing the decision, or in which they were recommending an option to a patient.

ACP Member Peter A. Ubel, MD, led the study, which appeared in the Archives of Internal Medicine on April 11.

The first hypothetical scenario involved two types of surgery for colon cancer. The first type of surgery cures colon cancer without any complications in 80% of patients, results in death within two years in 16%, and 1% apiece would experience a colostomy, chronic diarrhea, intermittent bowel obstruction or a wound infection. The second type of surgery cures 80% without complications, or results in 20% mortality within two years.

Among 242 respondents, 37.8% chose the treatment with a higher death rate for themselves but only 24.5% recommended this treatment to a hypothetical patient (P=.03).

A second, larger survey outlined a hypothetical new strain of avian influenza. Again, physicians were randomized to scenarios in which they’d either been infected themselves or were advising patients who had been infected. People who contract the flu virus have a 10% death rate from the flu and a 30% hospitalization rate, with a 1-week average length of stay.

An immunoglobulin treatment was available that halves adverse events to a 5% death rate and a 15% hospitalization rate, with a 1-week average length of stay. However, it causes death in 1% of patients and permanent neurological paralysis in 4%. Authors noted this scenario includes an arguably dominant option of less mortality while introducing adverse effects that the vast majority of people consider preferable to death.

Among the 698 respondents, 62.9% chose the outcome with the higher death rate for themselves but only 48.5% recommended this for patients.

*This blog post was originally published at ACP Internist*


You may also like these posts

Read comments »


2 Responses to “Evidence That Doctors Make Bad Patients?”

  1. Health Blog says:

    Very true that doctors make worst patients. I am yet to find a doctor who says doctors are good patients.

  2. did we really need study? lol

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »