When faced with making serious health-related decisions, patients often ask their physicians for advice. But what doctors counsel their patients to do may not be what they would do if confronted with the same scenario.

A study released Monday in the Archives of Internal Medicine surveyed physician specialists to see which treatment they’d choose for themselves, and which they’d recommend to their patients.

In the first scenario, 500 general internists and family medicine physicians were given hypothetical situations: They just learned they had colon cancer, or their patient had the disease. Both surgical treatment options cured colon cancer in 80% of people. One had a higher death rate but fewer complications, while the other had a lower death rate and complications such as chronic diarrhea and wound infections in a small number of patients.

About 38% of doctors said that if they had colon cancer they’d chose the surgery with a higher mortality rate but fewer side effects. About 25% said they’d recommend that surgery for their patients.


In the second scenario, 1,600 primary care physicians were asked to imagine what treatment they would choose for themselves or a patient who had contracted a new strain of avian flu. An immunoglobin treatment was offered: without it there would be a 10% mortality rate and a 30% hospitalization rate with a one-week average stay; with it the death from influenza and hospitalization rates were cut in half, but the treatment itself would cause death in 1% of people and permanent paralysis in 4%.

About 63% of doctors said they’d take the treatment with the higher death rate, but about 49% of them said they’d suggest patients do the same.

"...our study demonstrates that physicians’ decisions are significantly influenced by their perspective — they make different decisions for themselves than they recommend to others,” the authors wrote. “In both our scenarios, these differences led physicians to recommend the higher-survival option to patients more often than they chose it for themselves.”