Worrisome survey raises doubts about Dr.'s willingness to meet medical and societal responsibilities

[dajoki]

Editorial
Falling Short of Professional Standards
Published: December 24, 2007
http://www.nytimes.com/2007/12/24/opinion/24mon2.html?th&emc=th

Will American doctors be a help or a hindrance in efforts to raise the quality and cost-effectiveness of the nation’s health care system? A new, worrisome survey raises doubts about physicians’ willingness to meet their medical and societal responsibilities.

The survey, led by researchers at Massachusetts General Hospital, found a disturbing reluctance among doctors to report incompetent colleagues or serious mistakes by their peers. Although an overwhelming majority of some 1,600 doctors acknowledged that they should make such reports to hospitals, clinics or other relevant authorities, they often flinched when the occasion arose. Almost half of those who had direct knowledge of impaired or incompetent colleagues, or who knew of significant medical errors, had failed to report them at least once over the last three years.

The survey, published in The Annals of Internal Medicine, sought to measure attitudes toward a “charter on professionalism” that has been embraced by many medical organizations in an effort to define doctors’ responsibilities to their patients and to society.

In addition to raising questions about misplaced loyalties, several findings suggest that doctors could become an impediment to much-needed efforts to rein in health care costs. In response to a hypothetical question, a third of the doctors said they would order unneeded magnetic resonance imaging for back pain if a patient insisted. That bodes poorly for efforts to curb excess use of expensive technologies in order to control runaway spending. Similarly, a large majority said they would refer patients to an imaging facility in which they had invested, and one-fourth of the doctors said they would not disclose their financial conflict of interest to patients.

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The charter is a valuable attempt to define a doctor’s obligations — not only to individual patients but also to the health care system as a whole. It is comforting that a vast majority of physicians seem to accept the standards. Now they need to start adhering to them.