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Thursday, April 24, 2008

Don't save me because we're friends: Affective error by physicians

Dr. Karen Delgado [not her real name] is an acclaimed specialist in endocrinology and metabolism at a large urban teaching hospital. She cares for patients with hormonal and metabolic disorders such as diabetes, infertility, and hypothyroidism.

Dr. Delgado has genuine affection for many of her patients, so I asked whether she had ever fallen into the trap of affective error [where a doctor's feelings about a patient cloud clinical judgment]. She answered, "I had an elderly patient with thyroid cancer and considered treating him with radioactive iodine. There are difficult logistics involved with the therapy, and it really can disrupt the person's life. I was just about to refrain from treating this man when he said to me: 'Don't save me from an unpleasant test just because we’re friends.'"

Dr. Jerome Groopman's Advice: In severe circumstances, the family or friends of patients who realize that a doctor's affection may stay his hand at times can address this concern by saying, "You should know how deeply we appreciate how much care you show. Please know also that we understand you may need to do things that cause discomfort or pain."

Browse for related stories in the index at the very bottom of this page, or read another story from Dr. Groopman.

Thanks to Dr. Jerome Groopman for this excerpt from his book, How Doctors Think.

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