More than 1,800 physicians nationwide were surveyed to assess how much they actually live by the medical professional rules of being open and honest with patients. While most agreed that they should be completely open about risks, benefits, and treatments, more than half said they often sugarcoated patients' diagnoses.
The findings are discomfiting, but Evan G. DeRenzo, senior clinical ethicist at MedStar Washington Hospital Center's Center for Ethics, says there's more to it than just plain lies. "It's not as simple as saying, 'Oh, doctors just want to schmooze with their patients," she says.
Doctors have made their whole life’s work the care of other people, she explains. Due to the nature of their work, there are “deeply psychological barriers” that cause doctors to sugarcoat prognoses.
“From a personality perspective, physicians tend to be less conflictive than the average person,” DeRenzo says. “Those types of people are going to have a greater difficulty than the average person telling someone whom they’ve worked hard to make better that things aren’t going well or an error was made.”
The survey also found that one-third of the doctors said they did not admit mistakes to patients for fear of being sued. Says DeRenzo, “This is America. Patients can sue for what physicians do or don’t do.”
Therefore, she says, doctors should be trained to know that what angers families and leads to a lawsuit is lack of transparency. “When you talk to families or patients about what happened, whether it was an error or a nasty complication, they are usually accepting,” she says. “Nobody wants to be harmed in the process of medical care, but they are usually accepting enough of the answer not to sue.”
DeRenzo's best advice for physicians going forward? "Speak often, frankly, and fully with your patients and families."
To read an abstract of the study, click here.