Friday, April 22, 2011

Doctors choose differently for themselves than they would for their patients

In an investigation released on April 11 in the Archives of Internal Medicine, several hundred doctors were surveyed and asked questions about treatments that they would accept for themselves and ones they would recommend for their patients. Both hypothetical scenarios were situations where taking a treatment (avian flu vaccine or colon cancer treatment) carried some risk of disability from the treatment, but the treatment would reduce the chance of death. In both cases the doctors were more likely to recommend the treatment for their patients than they would be to take the treatment for themselves.

The authors took a pretty neutral stance about this in their conclusions and basically just said that something is going on in the doctors' minds which is generating this difference in self treatment and recommended treatments. The authors also do a reasonable job of questioning their own conclusions and pointing out limitations in this study. The first thing that came to mind for me is my awareness of bad outcomes. For example, when I see patients in the hospital, it is usually because they have had some complications from some disease they have or some procedure that they had done. (eg: bleeding after a catheterization, atrial fibrillation or heart attack after surgery, etc.) I would imagine that for many doctors, the awareness of these bad outcomes (which are usually rare) loom large in their mind when asked to make decisions about treatment for themselves.

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