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Double Standard for Doctors?

Doctors' Recommendations for Patients Often Different Than for Themselves, Study Finds

Doctors' Double Standards: Implications

How to explain what seems to be the double standard?

"I think the doctors, when they were imagining themselves as the patient, were saying, 'Yes, there is a higher survival, but I don't want to put up with these horrible side effects,'" Ubel says. "On the other hand, when they are making recommendations for the patients, it is easier to push those emotions aside.''

"The simple message is this," Ubel says. "When you ask your doctor for advice, recognize your doctor 's advice will depend on how he or she is weighing the pros and cons of really complicated things. Their recommendation is not going to be just the result of medical facts ruling the day."

Ubel gives this example. A doctor tells a patient he would like to add chemotherapy to a regimen that has already included radiation and surgery. ''That sounds like a medical recommendation," Ubel tells WebMD.

"But there is a huge value judgment underlying that. They think the side effects of chemo are worth the increased chance of survival. But what if there is a 1% reduction in the 15-year recurrence rate and it means six months of vomiting, hair loss, and misery?"

For that reason, he says, ''asking a doctor for advice would only be part of a conversation in which you determine the right or wrong decision. Make sure you have a nice conversation about the pros and cons of the alternatives and how you feel about those pros and cons. If your doctor understands your values better, you are likely to get a better recommendation."

Doctors' Double Standards: Perspective

The study findings suggest that doctors may weigh decisions more towards survival when recommending treatments for others, says Timothy Quill, MD, director of the Center for Ethics, Humanities and Palliative Care at the University of Rochester Medical Center, New York.

He wrote a commentary to accompany the study.

However, he says, it's important when making medical decisions to weigh both length of life and quality of life.

"When making decisions for themselves, the doctors [surveyed] were willing to take some survival risks to maximize qualify of life concerns," Quill tells WebMD.

He, too, advises doctors to find out the values and concerns of patients before recommending a treatment.

Asking your doctor that age-old question "What would you suggest if it were your mother or brother?" might be helpful, too, he says. "It forces them to think about the quality-of-life concerns."


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