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February 09, 2012 12:44 PM Are Physicians Honest with Patients?

By Aaron Carroll

Not as often as you’d hope. There’s a new study in Health Affairs on the subject:

The Charter on Medical Professionalism, endorsed by more than 100 professional groups worldwide and the US Accreditation Council for Graduate Medical Education, requires openness and honesty in physicians’ communication with patients. We present data from a 2009 survey of 1,891 practicing physicians nationwide assessing how widely physicians endorse and follow these principles in communicating with patients.

So what did they find? Well, first of all, only 89% of physicians completely agreed that they should fully inform all patients of benefits and risks of procedures and treatments. Even fewer (83%) thought physicians should never tell a patient something that wasn’t true.

But when it comes to disclosure, they looked even worse. More than a third did not completely agree that physicians should disclose all significant medical errors to affected patients. About the same number did not completely agree that physicians should disclose financial relationships with drug and device companies to patients. My bet is that the former is because they think it will lead to lawsuits. My bet is the latter is because they think such relationships would be “misunderstood”. I find that rather unconvincing. If there’s nothing to hide, well, then there’s nothing to hide.

They survey also asked specifically about things subjects had actually done in the last year. That’s where it gets even more depressing. More than 10% of docs had told an adult patient or guardian something that wasn’t true. Almost 20% had – in the last year – not fully disclosed a mistake because they were afraid of being sued. And more than a quarter of physicians had revealed, either intentionally or unintentionally, personal health information of one of their patients to an unauthorized person.

I applaud the honesty of those answering the survey, but we’ve got to do better. We cannot, as a profession continue to think that we are immune to conflicts of interest (and yet want to hide them). We cannot, as a profession, not be truthful with those who entrust us with their care. And we cannot, as a profession, fear potential accountability so much that we hide mistakes from our patients, especially when honesty has been shown to make lawsuits less likely.

We’re better than this.

[Cross-posted at The Incidental Economist]

Aaron Carroll ,MD, is an associate professor of Pediatrics and the associate director of Children’s Health Services Research at Indiana University School of Medicine.