A survey of US physicians finds that some are less than completely honest or forthcoming with information when talking with their patients. (VisualField/iStockphoto.com)
The Charter on Medical Professionalism, which is 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. In 2009, to see if physicians adhered to the charter, a research team led by Lisa Iezzoni, MD, MSC, a professor of medicine at Harvard Medical School in Boston, surveyed (via an 8-page questionnaire) US physicians from 7 specialties; 1891 of the 2938 physicians who met the eligibility criteria (about 64%) responded.
The researchers found that the vast majority of physicians completely agreed that they should fully inform patients about the risks and benefits of interventions and should never disclose confidential information to unauthorized people. However, the survey also revealed that about one-third of physicians did not completely agree that they should disclose all significant medical errors to patients, about one-fifth did not completely agree that they should never tell a patient something untrue, and almost two-fifths did not completely agree that they should inform their patients about financial relationships they might have with drug or device companies.
Women, underrepresented minority physicians, and graduates from offshore medical schools were more likely to follow the charter’s provisions on honest communication compared with white male physicians trained in the United States or Canada. General surgeons and pediatricians were most likely to completely agree about the need to disclose all serious medical errors to patients; cardiologists and psychiatrists were least likely to report this attitude.
The survey also found that more than half of physicians in the previous year had described a patient’s prognosis in a more positive manner than warranted and almost one-fifth did not fully disclose a mistake to a patient for fear of being sued.
Iezzoni said in a statement that her team’s findings don’t bode well for truly implementing patient-centered care that focuses first and foremost on the needs and desires of patients: “Patients who do not get the full story might not be able to make an informed choice about the best course of action for their care.”
