Wednesday, February 22, 2012

Lying to patients: Part II of a two-part series

In Part I, we established that not only do physicians lie to patients; they lie about how frequently they lie to patients. So why do they lie to patients?

Apparently, it’s because they lie about other things too. Two recent papers illustrate the point.

A group from the M. D. Anderson Cancer Center in Houston reviewed 243 applications to their gynecologic oncology fellowship and found the following:

Applicants listed over 400 articles published but only 83% of these could be verified. And 30% of applicants who listed published papers had at least one unverifiable paper.

Hard to believe, but male gender was statistically significantly more likely to be associated with the deception.

The results reported in the above paper were remarkably similar to those found with applicants to a general surgery residency program in a paper from 2008.

The authors, from Duke University, looked at almost 500 applications to their program. They found that of 596 publications listed, 33% could not be verified. And of the 150 applicants who listed publications, 33% had one or more unverifiable publications.

In this paper, factors associated with unverifiable publications were older applicants and graduation from a foreign medical school.

If these papers are accurate [Can we believe them or anything else? After all, the two papers were written by doctors.], inflating one’s curriculum vitae is very common.

It is no wonder that doctors lie to patients.


Anonymous said...

Yeah, sometimes a nurse can trip over one of those lies without knowing it. Makes for awkward patient conversations.


Skeptical Scalpel said...

Thanks for pointing out yet another reason to tell the truth. If you aren't planning to do so, you better make sure everyone who interacts with the patient is willing to lie too.

Golden Duffer said...

OK, so doctors lie to patiens and their families. I can accept that if it's hiding bad news when revealing it won't make any difference in prognosis, treatment, or preparation for the outcome (not too many cases, right?). I can't accept it when it comes to mistakes - everyone should be able to own up to making a mistake, apologizing, and moving forward to the best of their ability.

Now, what about all the patients who lie to their doctors? "No, I don't smoke" (except cigarettes, cigars, and the nightly joint) or "no, I hardly ever drink" (except to be social, to unwind, or to get frisky). Then there's the "I only take over-the-counter medicines like aspirin" (except for that Xanax I got from my sister and the little blue pill I got from my brother-in-law).

It would seem that honesty is one of the rarest commodities in the healthcare marketplace, wouldn't it? I often wonder how much money could be saved on healthcare every year if both doctor and patient were completely open and completely honest about the circumstances surrounding symptoms, diagnosis, and treatment. Probably in the $$billions!

Anonymous said...

Hospital care is very fractured, and sometimes I would have to tiptoe around diagnoses and information that residents and attendings had avoided telling the patient or outright covered up, because it wasn't clear who's job it was to break things to the patient, or even who would be best at it. I suppose this is difficult when each member of the 'health care team' often fails to communicate responsibilities with each other, and sees the patient for minutes at a time if even that. Add that to the fact that residents carry a patient for a month or so while they are on a particular unit, that signout and handoff procedures often don't include items disclosed to patients, sometimes its almost as if its hard to tell the truth to patients at all.

Skeptical Scalpel said...

Apologies to Golden Duffer. I missed your comment until now. I'm glad I did because an article just came out today that describes what can happen when one tells the truth and apologizes. Here's the link

Anonymous, thanks. Your points are valid.

Anonymous said...

Does the paper account for the possibility that older students and those who went to a foreign school might simply be more likely to have published in a journal that is not well-known or online? I wonder how frequently "unverifiable" means simply unverifiable and not untrue.

Skeptical Scalpel said...

I believe the searches for the journals and publications were quite thorough, although that level of detail was not mentioned. However, a few of the citations may have be of the type you suggest.

Anonymous said...

As a trusting patient, let me say that my experience is evocative of the exchange between Otter and Flounder in Animal House where Flounder is complaining about his destroyed car. Otter's reply is, "You fucked up. You trusted us."

Skeptical Scalpel said...

That was a great line, one of many from that movie. My favorite is "Was it over when the Germans bombed Pearl Harbor?"

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