Physicians Choose Low Death Risk Treatment for Patients

However, make different decisions for themselves, opting for high mortality risk treatment

TUESDAY, April 12 (HealthDay News) -- Physicians recommend low mortality risk treatment with more adverse effects for their patients but opt for higher mortality risk treatment with less adverse effects for themselves in a similar scenario, according to a study published in the April 11 issue of the Archives of Internal Medicine.

Peter A. Ubel, M.D., from Duke University in Durham, N.C., and colleagues assessed how decisions of U.S. primary care physicians (general internists and family medicine specialists) are influenced by the act of making a treatment recommendation in fatal illness. They presented a colon cancer scenario to 242 physicians and an avian influenza scenario to 698 physicians. Both scenarios involved two treatment alternatives, of which one had lower mortality risk with the potential of more unpleasant adverse effects. Physicians were randomly assigned to indicate which treatment they would prefer for themselves and which they would recommend as a treatment option for their patients.

The investigators found that 37.8 percent of the physicians in the colon cancer scenario chose the treatment with an increased mortality rate for themselves, but only 24.5 percent recommended this to their patients. In the avian influenza scenario, 62.9 percent of the physicians chose the higher mortality risk treatment for themselves and 48.5 percent recommended this for their patients.

"In debating when it is appropriate for physicians to make treatment recommendations to their patients, we must now recognize that the very act of making a recommendation changes the way physicians weigh medical alternatives," the authors write.

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