Doctors seem to differ in making medical recommendation for patient versus for themselves

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