Many of us feel we can put all of our faith into our healthcare providers, trusting they have our best interest in mind.
We treat them as experts, as an authoritarian figure that we should agree with.
This isn't necessarily their goal, for us to trust them blindly.
But we do live in a culture that trusts experts over personal instinct in nearly every aspect of life.
If a doctor says you need surgery, well, you need surgery, right?
If they recommend a medication, procedure or give you a clean bill of health, it must be because it's the only proper action to take.
Or is it?
While the vast majority of healthcare providers truly do care, the reality is they aren't infallible. Just like every other human being, they make mistakes.
Even when they truly care about you, your health and your wellness, they might not always be honest or correct with their recommendations.
A survey published in 2012 found nearly 20% of the 1,891 surveyed physicians did not agree that a physician should never tell a patient something untrue.
This belief contradicts The Charter on Medical Professionalism, which is endorsed by over 100 professional groups around the world, as well as the US Accreditation Council for Graduate Medical Education, which requires openness and honesty in physicians’ communication with patients.
Why Is This Information Important?
The information from this survey isn't a reason to distrust your medical providers. Nor is it a reason to develop an ‘us versus them' mentality. However, it does show us the importance of being our own advocates and an active participant in our healthcare.
When we have realistic expectations, we can make fully informed decisions. We will know to ask more questions and seek another opinion, if advice isn't sitting well. We can also remember that our healthcare providers aren't an authority figure. They can give us an opinion or option, but it’s not a hard and fast set of instructions.
Why Would A Doctor Lie?
Physicians are people, just like us. Often when someone is lying, they do so because they feel the truth might make a situation more difficult. In some cases, it's the belief that the ends justify the means.
This particular survey found that of the 1,891 physicians surveyed:
- Around one-third did not completely agree with disclosing serious medical errors to patients
- Nearly one-fifth did not completely agree that a physician should never tell a patient something untrue
- Approximately two-fifths didn't believe they need to disclose their financial relationship with drug or device companies
- Just over one-tenth said they had told a patient something untrue within the last year
Not wanting to disclose financial relationships could mean they're concerned about your trust in their recommendations. However, as their patients, it's important that we know why they are recommending a specific device or medication. While having a financial relationship might not impact their advice, we should have all the information available to us. Then we may be able to determine if their recommendation truly feels genuine and medically sound. Some of us are not comfortable being prescribed products that will result in some sort of incentive.
In our litigious society, it's not surprising that physicians are concerned about disclosing errors. Physicians are human, and thus they will occasionally make mistakes. It's understandable if they’re concerned about disclosing when it could mean lawsuits. However, without knowing about their errors, we are aware of only a portion of our medical history, which could impact our future choices. Prior to procedures, it's important that we’re able to provide fully informed consent, and be made aware of errors that could occur.
At times, a physician might assume you would prefer not to hear about potential risks, a difficult prognosis or burden you with choice. However, as patients we do have the right to informed consent. This cannot be given when a physician tells us something untrue or omits information – even if it's done with good intentions.
What Importance Does This Have In Maternity Care?
Pregnancy is a time when most women see a healthcare provider often. It's a time where big decisions are made, and the choice to accept or deny a procedure or medication is a big one. Pregnancy is also a very vulnerable time, a time where a woman should really be able to trust her care providers.
While having access to the most modern obstetrical care sounds wonderful, current maternal and fetal health statistics show otherwise. With nearly one in three women giving birth via c-section and in some areas, more than half receiving artificial oxytocin (Syntocinon or Pitocin) for an induction of labour, we can't help but wonder if women are presented with the opportunity to give true, fully informed consent. And we never hear of a doctor saying, “Actually, I'm sorry, that procedure wasn't really needed after all,” because all that does is open them up to legal reasons to sue. Yet we know many procedures are done unnecessarily.
The World Health Organization recommends a c-section rate of 10-15%. In many developed countries, like the US, UK and Australian, the c-section rate is closer to 30%. This means that around half of all women giving birth via c-section might be doing so without medical necessity – possibly because they were presented with untrue information.
What Does This Mean For You?
As mentioned above, this information isn't meant to cause distrust with your healthcare providers. This was a small survey, and the majority did agree with the importance of honesty. What it does mean is it's important to be an advocate for yourself and choose healthcare providers that you trust. Always ask about your care providers beliefs and philosophies about treatments and procedures, as well as their rates of c-section and induction, for example.