"In such cases, the natural assumption is that the patient's doctors would make the same decision as you would, but that's not necessarily true because they're seeing the situation from a different perspective," says Zikmund-Fisher, a decision scientist and research investigator at the University of Michigan Medical School's Center for Behavioral & Decision Sciences in Medicine who also holds a VA position.

Just as the participants in the new study did when they put themselves in the shoes of a doctor or medical director, medical professionals may tend to choose more proactive treatment even if it carries risks, the researchers say. From their perspective, taking action is a more justifiable choice than doing nothing and accepting even greater risks. The same is true for medical directors of hospitals or insurance plans, who must make defensible, justifiable decisions for groups of patients.

The study's results also suggest that doctors should not shy away from guiding patients' choices, as some studies have suggested may be happening in this age of "consumer-driven" health care. Doctors can provide a valuable perspective on a medical choice, without being paternalistic, when they present patients with information about their condition and treatment options.

The study's senior author, Peter Ubel, M.D., director of the CDBSM and a professor of internal medicine at the U-M Medical School, believes that the study sheds light on tension in the doctor/patient relationship: "Most people try to follow the golden rule, doing unto others as they'd do unto themselves. But in this study, people seem to be following some other rule; the platinum rule, maybe? They do differently unto others than they would do unto themselves and, for the health situations we studied, they ac
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
31-May-2006