Sun Feb 17, 2019 | 13:40
Doctors act risky on their own treatment
Tue, 12 Apr 2011 09:07:33 GMT
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Physicians usually do not follow their own recommendations and choose risky treatments instead when confronting with the same scenario themselves.

A survey of 940 primary-care physicians showed that, when doctors imagined themselves as the patient, they more often chose treatments that pose a higher risk of death but fewer severe side effects.

During the study, researchers put two groups of participant doctors in different situations to compare their choice while suggesting treatment to a patient and at the time, they decide for themselves.

In the first scenario, 500 physicians were asked to choose a treatment for colon cancer. Both surgical treatment options cured colon cancer in 80 percent of people but one had a higher death risk with lower complications.

According to a report published in the Archives of Internal Medicine, about 38 percent of doctors chose the surgery with a higher death risk but fewer side effects for themselves while only 25 percent said they'd recommend that surgery for their patients.

In the second part of the study, 1,600 doctors were asked to decide about prescribing a drug for a new strain of avian flu. Without this treatment, a patient would have a 10 percent risk of death and 30 percent risk of hospital admission.

The medication would halve the rate of adverse events but also caused death in 1 percent and permanent paralysis in 4 percent of patients.

About 63 percent of doctors said they would take the treatment with the higher death rate, but about 49 percent of them said they would suggest patients do the same.

"In both our scenarios, these differences led physicians to recommend the higher-survival option to patients more often than they chose it for themselves," wrote Dr Peter Ubel and his colleagues from Duke University.

“Our study demonstrates that physicians' decisions are significantly influenced by their perspective; they make different decisions for themselves than they recommend to others," researchers added.

However, the scientists noted that their findings did not suggest that physicians always make better decisions for others than they would make for themselves.

"At most, our study suggests that in some circumstances, the act of making a recommendation might improve decision making," the researchers said.

Some advocates of giving patients a more active role in their care contend that doctors shouldn't make recommendations, but instead should neutrally present options, an Archives editorial notes.

But in tough situations, "it might not be fair to lay out the a la carte options and leave it to the patients" to decide, said editorial co-author Dr. Roshni Guerry.

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