The Doctor Weighs In

This is an interesting story to follow yesterday’s post on supply-driven demand in healthcare. The results of a WSJ Online/Harris Interactive Health-care Poll are in and they show that many Americans don’t follow their doctors’ advice. It is pretty interesting stuff.

Seventy-two percent (72%) of folks polled answered “often” or “sometimes” to the questions “based on what you know or have heard, how often do you think patients who have medical conditions experience problems because of being over-treated, for example, by getting too many treatments or by getting more aggressive treatment than is appropriate.” Only 5% of people said it never happens.

Eighty-three percent (83%) of people said patients are often/sometimes under-treated. The poll did not ask how often the respondents thought people were treated appropriately.

Only 43% of people (down from 50% in 2005) were “very” or “somewhat” concerned about overly aggressive treatment. In fact, 57% said they were not very or not at all concerned about it. Hmmm?

Thanks, but no thanks.

The poll shows that:

• 27% did not fill a prescription given to them by their doctor
• 20% sought a second opinion because they thought their doctor’s advice was too aggressive
• 13% did not get a recommended diagnostic test.
• 7% did not get a recommended surgical procedure
• And, 7% of people changed doctors because they felt their doctor’s approach was too aggressive.

And, maybe they were right

Only a handful of people who chose to forgo recommended treatment experienced any negative outcomes as a result. Two percent (2%) experienced a new medical problem or complication, 2% required hospitalization, 4% lost time from work or school, 3% went to an ED, and 3% said their health got worse. A whopping 89% said nothing negative happened as a result of ignoring their doctor’s advice.

So why do these people think docs are overly aggressive?

More than half of respondents think doctors over treat patients because they are worried about malpractice lawsuits. Forty-one percent (41%) thought docs did it to make more money. Forty-four percent (44%) were less cynical about doctor’s motives. They thought doctors were overly aggressive to meet patients’ demands. Now, here is one that is really worrisome, almost a third thought docs were too aggressive because they received misleading information form the prescription drug or medical device companies.

So what’s a doctor to do? If you are less aggressive, you might get sued. If you are too aggressive, your patient might ignore you, or worse yet, find another doctor. And, what if you get it just right? What happens then? You might get thanked. You might get paid. And you might just feel good enough about what you are doing to get up and do it another day.