Patients facing difficult medical decisions
often ask physicians for recommendations. However, little is known regarding
the ways that physicians' decisions are influenced by the act of making a
recommendation. Many medical/treatment decisions are
difficult to make since various factors are involved. Having been a patient myself, I usually just
told my own doctor to do what is best for me.
A study in medical decision making seems to suggest that it is even more
complicated than I thought. In a study,
242 doctors were surveyed and questioned with 1 of 2 clinical scenarios (having
colon cancer or suffers from avian influenza).
Both involved 2 treatment alternatives, 1 of which yielded a better
chance of surviving a fatal illness but at the cost of potentially experiencing
unpleasant adverse effects. The researchers randomized physicians to indicate
which treatment they would choose if they were the patient or they were
recommending a treatment to a patient.
Among those asked to consider a
colon cancer scenario (n = 242), 37.8% chose the treatment with a higher death
rate for themselves but only 24.5% recommended this treatment to a hypothetical
patient (χ(2)(1) = 4.67, P = .03). Among those receiving an avian influenza
scenario (n = 698), 62.9% chose the outcome with the higher death rate for
themselves but only 48.5% recommended this for patients (χ(2)(1) = 14.56, P
< .001).
The conclusion of the paper was
physicians (at least in this study) making a different recommendation for
patients and for themselves. The study researchers commented on how physicians perhaps more careful in making decision for their patients and the need to be be publicly defensible than if they were to make decision for themselves. The study did not conclude that physicians would be a better doctor for themselves. I agree with this since I know that I am so biased about myself that I am afraid making diagnosis for my own symptoms. But if you
happen to be in the situation needing medical decision and unable to decide
yourself, you may ask your doctor what your doctor would do
if he/she were you. This may give you a different perspective.
Reference
Ubel PA, Angott AM, Zikmund-Fisher BJ.Physicians recommend different treatments for
patients than they would choose for themselves. Arch Intern Med.
2011 Apr 11;171(7):630-4
No comments:
Post a Comment