A new report shows that not all physicians agree on how forthcoming they should be with patients, but this should not be viewed by the public as evidence that most doctors lie, according to a senior clinical ethicist.
Evan DeRenzo, PhD, of the Center for Ethics at Washington Hospital Center in Washington, D.C., says the report, "Survey Shows that at Least Some Physicians are not Always Open or Honest With Patients," published last month in Health Affairs, is useful for sparking discussion of professional ethics, but adds that medicine is an art, and communication with patients is a subjective topic.
Physicians should ask themselves, "How much information is the right amount of information for this particular patient to grasp the most important parts of the panoply of information?" she says.
Dr. DeRenzo says that fraud or abuse is both illegal and unethical but, in most situations, what and how to communicate with patients or colleagues is "not black and white." The Health Affairs report surveyed 1,891 physicians nationwide and found that about one-third of doctors don’t “completely agree” that they should “disclose all significant medical errors to affected patients.” More than 35% of respondents did not completely agree they should disclose to patients financial relationships with pharmaceutical companies or medical device firms, and 11% reported that they had told patients something false.
Dr. DeRenzo believes that a stronger focus on training physicians to communicate with patients and colleagues would help instill a sense of how best to ethically handle discussions. She adds that the construct on how to best communicate is not dependent on specialties, but on common sense.
"I don't see any difference whether [the communication is] hospital to community, surgery to medicine," she says. "I don't see any difference at all because you're talking about how do we communicate with patients, what are the optimal ways to convey and exchange information, and how ought physicians—hospitalist, surgeon, community doctor, it doesn’t matter—act in the best interest of their patient."