Physicians Often Do Not Follow Professional Standards

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Many physicians in some cases have failed to report a seriousmedical error or an impaired or incompetent colleague, although theirprofessional standards require such actions, according to a surveypublished on Monday in the Annals of Internal Medicine, the USA Today reports (Rubin, USA Today, 12/4).

For the study, researchers led by Eric Campbell of the Institute for Health Policyat Massachusetts General Hospital from November 2003 to June 2004mailed a survey to 3,504 U.S. internists, family practitioners,pediatricians, surgeons, cardiologists and anesthesiologists andreceived 1,662 responses. The survey asked respondents whether theyagreed with 12 specific statements about fair distribution of limitedresources, improvement of health care access and quality, management ofinterests and self-regulation by physicians (Kowalczyk, Boston Globe, 12/4). Physicians received a $20 check with the survey (AP/Boston Herald, 12/4).

Accordingto the study, 46% of respondents said they failed to report at leastone serious medical error, although 93% said that physicians shouldreport such errors in all cases. Forty-five percent of physicians saidthat in some cases they failed to report an incompetent or impairedcolleague, although 96% said that physicians should report suchcolleagues in all cases, the study found. In addition, the study foundthat:

  • A majority of respondents saidthat they would refer patients to a medical imaging facility in whichthey had financial ties, although only 24% would inform patients oftheir financial ties;
  • 96% of respondents said that physicians should place the welfare of their patients above their financial interests;
  • 36%of respondents said that they would order an unnecessary MRI forpatients with back pain, although most said that they opposeunnecessary use of medical resources;
  • 93%of respondents said that physicians should provide medical care topatients who cannot afford to pay, and 69% said that they acceptpatients who lack health insurance (Lee, Washington Post, 12/4);
  • 98%of respondents said that physicians should seek to reduce health caredisparities based on gender or race, although only 25% said that theyhave sought to identify such disparities (Stanchak, CQ HealthBeat, 12/3); and
  • Lessthan 1% of respondents said that they had lied to the family of apatient in the past three years, and 3% said that they had withheldinformation.

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According to the Boston Globe, thestudy sought to measure the "success of a new movement called 'medicalprofessionalism'" -- which maintains that "government regulation,financial incentives and public reporting alone will not improve thequality and efficiency of medical care" and seeks a modernization ofthe professional standards of physicians to address financial conflictsof interest, health care technology, medical errors and health caredisparities (Boston Globe, 12/4).

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Campbell said, "We found large gaps between physicians' espousedattitudes and what they do in actual practice," adding, "Failing toreport incompetent physicians and allowing them to practice will havean impact on the welfare of patients. It's clearly something thatpeople should be aware of" (Washington Post, 12/4). Inaddition, Campbell said, "This raises serious questions about theability of the medical profession to regulate itself" (CQ HealthBeat, 12/3).

DavidBlumenthal, a co-author of the study and director of the Institute forHealth Policy, called for an increased focus on professional standardsamong physicians, rather than increased regulations, to address theissue. He said, "If the medical board and regulatory apparatus weremonstrous, it wouldn't solve our problems," adding, "Sure, regulationhas an important role. Yes, patient information has an important role.But in the end, if the profession doesn't step up, we will all be theworse for it" (Washington Post, 12/4).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily HealthPolicy Report is published for kaisernetwork.org, a free service of The HenryJ. Kaiser Family Foundation.

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