A study was published this month in the journal Archives of Internal Medicine that has pretty profound implications for the doctor-patient relationship. This study found that doctors weigh the potential adverse reactions to a medical intervention differently for themselves than they do when making recommendations to their patients. The conclusion of the study is that "The act of making a recommendation changes the ways that physicians think regarding medical choices. Better understanding of this thought process will help determine when or whether recommendations improve decision making."
The interpretation that I come to from this is that patients are best served by asking doctors for information rather than for recommendations. The study was done by giving doctors a hypothetical situation and asking them to choose between two alternative treatments with different risk patterns. It seems to me that the patient is best served by asking the doctor for information about the treatment options and their risks and then making their own decision about which risks they are most willing to take. The implications of this study for vaccination are unavoidable- when making vaccination decisions, it is your family and your child who is taking on the risks- shouldn't it be your family that ultimately makes this decision?
This is an article that gives a little more background about how the study was done and the specific questions that were asked. Doctors were asked about hypothetical treatments for either colon cancer or an outbreak of avian flu. In the case of the hypothetical avian flu outbreak:
"The avian influenza scenario survey was returned by 698 doctors and a whopping 62.9 percent of them said they'd personally refuse the immunoglobulin treatment when imagining they had been infected, in order to avoid its adverse effects. But what decision did the docs make when imagining that a patient had been infected with the avian flu? The vast majority stated they'd recommend the immunoglobulin shots."
