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Doctors take chances with their health

A doctor examines a patient at a hospital.

Kai Ryssdal: You go to the doctor, she hears your problem, she gives you some advice and guidance and you walk away thinking that's the same set of recommendations she'd follow herself. Seems totally reasonable.

And possibly quite entirely wrong. Because a study out today from Duke University shows that if you ask a doctor: 'What do you recommend I do?' and then you ask, "Yeah, but what would you do if you were me?' -- you might get two different answers.

From the Marketplace health desk at WHYY in Philadelphia, Gregory Warner explains how wearing the white coat changes everything.


Gregory Warner: Professor Peter Ubel asked hundreds of doctors around the country to imagine this:

Peter Ubel: Imagine that this terrible avian bird flu is coming to town. Would you get a vaccine that would keep you healthy from getting the flu, but it does have a chance of paralysis?

Warner: Paralysis?

Ubel: Oh yeah, I'm sorry just your legs become so weak you have to get around on a wheelchair. And many of the doctors said, 'Ugh, I don't want that vaccine if it's going to cause me to be in a wheelchair.' They were taking their chances on dying of the flu.

He then asked doctors what they would advise a patient.

Ubel: Those same doctors would recommend getting the vaccine.

This seemed especially curious to Peter Ubel. He's not only a business professor at Duke -- he's a doctor.

Ubel: We're weighing the pros and cons differently when we're making a decision for ourselves, than for someone else.

Studies have shown that American doctors tend to recommend more aggressive treatments for their patients than those patients would choose for themselves. This can drive up the cost of care. Last month, Medicare unveiled a plan to reward doctors for taking that extra time to discuss treatment options and risks with their patients.

Michael Barry is with the Foundation for Informed Medical Decision-Making.

Michael Barry: In the past, care has been a little too much slanted towards clinician preferences, and patient preferences haven't been clearly expressed.

Peter Ubel says his own patients can make their preferences quite clear. They tell him, Doc...

Ubel: Do anything you can to keep me out of a wheelchair because I'd rather be dead. And that is almost always wrong.

Eventually they realize that life in a wheelchair isn't the end of the world.

Ubel: But they don't predict that upfront.

He says they need doctors -- and the doctors need doctors -- to predict it for them.

In Philadelphia, I'm Gregory Warner for Marketplace.

About the author

Gregory Warner is a senior reporter covering the economics and business of healthcare for the entire Marketplace portfolio.

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