In reply In response to our article, Dr Sutton argues that the solution to incidental findings is not to limit their presence, but rather to improve physicians' ability to interpret them and explain their limitations to patients. We certainly agree that current medical training in patient communication is inadequate and suspect that many physicians could benefit from an improved understanding of Bayesian statistics. However, these solutions are not mutually exclusive. There is no reason why the health care system could not both improve physician training as well as implement the simple steps we have proposed to limit unsolicited diagnostic information. These steps would not be a panacea and would not be applicable to every clinical situation. But, as we have discussed in our article,1 to rely entirely on physicians' and patients' ability to process information would be to ignore a vast body of literature demonstrating that humans are not always rational creatures and that, consequently, suspicious information is hard to ignore, even when people know that it is in their best interests to do so.2 And yes, we still perform physical examinations on our patients! Back to top Article Information Correspondence: Dr Volk, Department of Internal Medicine, Gastroenterology, and Hepatology, University of Michigan, 300 N Ingalls, Room 7C27, Ann Arbor, MI 48109 (email@example.com). Financial Disclosure: None reported. References 1. Volk ML, Ubel PA. Better off not knowing: improving clinical care by limiting physician access to unsolicited diagnostic information. Arch Intern Med. 2011;171(6):487-48821444838PubMedGoogle ScholarCrossref 2. Ubel PA. Free Market Madness: Why Human Nature Is at Odds With Economics—And Why it Matters. Boston, MA: Harvard Business Press; 2009
Archives of Internal Medicine – American Medical Association
Published: Sep 26, 2011
Keywords: health care systems,best interest standard
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