I meant what I said, I said what I meant . . .

. . . or did I?  Maybe not, if I were a physician.  The Annals of Internal Medicine published a study last week concluding that

Physician behavior did not always reflect the standards they endorsed. For example, although 96% of respondents agreed that physicians should report impaired or incompetent colleagues to relevant authorities, 45% of respondents who encountered such colleagues had not reported them.

Self-regulation ought to be working, but apparently it isn’t; nevertheless, additional regulation is probably not the solution.

Merrill Goozner, at GoozNews, notes that journalists seem to be able to self-regulate — though journalistic errors are not often life-or-death issues.  He continues:

Unfortunately, medicine’s professional societies are having a difficult time moving beyond their role as guilds designed to protect the economic interests of their members.

Read more about the study in the Washington Post, and further analysis at Roy Poses’ Health Care Renewal.

Other bits of cognitive dissonance, cited in the WaPo story:

[A] majority said they would refer patients to an imaging facility in which they had a financial interest, but only 24 percent would inform patients of that financial tie. Yet 96 percent told researchers that doctors should put their patients’ welfare above their own financial interests.

Also, more than a third of physicians, 36 percent, said they would order an unneeded MRI (magnetic resonance imaging) test if it were requested by a patient with low back pain, though most doctors say they do not want to waste scarce resources.

And while 93 percent said doctors should provide necessary medical care regardless of a patient’s ability to pay, only 69 percent currently accept uninsured patients who are unable to pay. 

Roy’s conclusion:

It’s easy to say that individual physicians always ought to do the right thing, regardless of external pressure. Maybe the individual physicians who feel uncomfortable being pressured into doing the wrong thing might get better organized to resist this pressure.

It would be even more helpful if medical and health care leaders could actually support physicians who want to do the right thing. Given that many medical and health care leaders have vested interests that push them in opposite directions, they may not jump at this opportunity.

Understatement of the week.

— David Harlow