Whatever You Say, Doc

Hmm. Skeptical Scalpel (via Grunt Doc) writes about a paper from the Archives of Internal Medicine that suggests that people who are more satisfied with their doctors have higher mortality rates than those who are less satisfied.

The post suggests that this is because people tend to be more satisfied when their doctor does what they want (like prescribing the medication they ask for), even if this is not necessarily the best course, medically. So maybe people are asking for drugs they see on TV, or whatever, and the doctor wants the patient to be happy and prescribes it, even if some other treatment might better control the condition.

There are interesting questions to ponder here about paternalism vs. patient involvement in care, and how well patients can expect to understand the fine points of treatment, and how much physicians should try to please their patients as opposed to sternly laying "doctor's orders" if their judgment indicates (but if your patients don't like you and leave to find someone who will give them the prescription they want, what good have you really done?).

I mean, we want people to understand their health and be involved with their medical treatment and so forth. At least, we do as librarians. Consumer health information! Why do we promote it if not to get people engaged?

And yet, no matter how much we read up on things, we still don't necessarily have a grasp on all the details and the background and the complicating factors, and there are times when we may do well to assume that our doctors understand it better than we do and trust to their judgment.

The paper is here, and I'll have to read it sometime, but right now I have to go to bed more than study.