New US Study Shows Doctors Would often not Take Their Own Advice

18th January 2012

Reports of a new study in which experts asked 1,000 US physicians a series of questions, revealed that they would not always, or indeed often, take their own advice, which calls into question the advice they give patients. If patients are to make informed decisions about the treatment they should have for a medical complaint, doctors need to give them the information they require to make an informed choice as to which course of treatment they will follow.

Doctors were given scenarios in which they had to recommend a treatment from a choice of two for a patient, and were then asked which course of treatment they would follow if they were the patient. The results showed that doctors, if they were the patient would choose the treatment which risked a chance of death, but which would give them fewer side-effects after the treatment, so their quality of life would be improved rather than the treatment which they recommended for patients which often meant a better chance of survival but perhaps with quality of life being impaired.

In one scenario doctors were given a choice of two surgical procedures to treat bowel cancer; two fifths of the 242 physicians who responded chose the operation which carried the greater risk of death, but which would, if successful have fewer long-term side effects. When asked which procedure they would recommend to patients ¼ chose the one with the lesser risk of fatality, but which would have more side effects after the operation.

In another scenario the physicians were asked to imagine that a patient came to them, who had a new case of bird flu, and there were two drug treatments available, one carried a 10 % risk of death plus a 30% risk of needing hospital care. The treatment led to death in only 1% of cases, but 4 % suffered permanent neurological damage. Out of the 700 doctors who responded, two-thirds chose not to have this treatment if they were the patient, although half recommended this treatment for a patient.

Luckily, treatments in real life do not have such a high risk of death or permanent neurological damage. Popular drugs like Fioricet and Flexeril are widely prescribed and any side effects reported are mostly mild. A medication with a 1% risk of death would never really be available as it wouldn't pass FDA approval, but none-the-less, the scenario provides an alarming issue that physicians would not follow the advice that they often provide their patients.