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Wednesday, September 10, 2008

Doctors keep secrets: Tell us what yours has kept

Your doctor keeps secrets from you -- and a new book reveals them.

Dr. David Newman, a New York City emergency physician, tells what doctors don't want you to know in his book, Hippocrates' Shadow: Secrets From the House of Medicine (Scribner, $26).

• • Doctors do know that many tests, drugs and procedures they order and prescribe either don't work or haven't been proved. Case in point: They keep prescribing antibiotics for colds and bronchitis.

• • Doctors like ordering tests better than they like listening to you.

"These doctors are not bad human beings,'' said Newman, who trains medical students and residents at Columbia University.

Time limits, lawsuit fears and the demands of insurers deserve some blame for the truth gap, but medical training and traditions play big roles, he said.

Take the antibiotic problem. Studies show that half of all patients who go to a doctor with a cold are prescribed an antibiotic. Colds are caused by viruses; antibiotics kill only bacteria. "Doctors think patients want a prescription," Newman says. They also know that patients feel better once they get that "magic pill," he said.

But doctors should know that patients are just as satisfied when physicians take a few minutes to explain why antibiotics won't help and suggest symptomatic relief -- relief that won't come, as some antibiotics do, with side effects such as diarrhea, yeast infections and allergic reactions.

Doctors also don't like to admit that many test results are not as black and white as they appear.

"It's not uncommon for the decisions we make to be entirely based on opinion," he said.

Letting patients in on these secrets allows them to make better, more healthful choices, he said.

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