The advice doctors give you isn’t necessarily what they themselves do when faced with a medical situation.  That’s the takeaway from a recent article in the Archives of Internal Medicine.

Researchers asked physicians how they would handle two medical situations that required them to weigh the likelihood of a cure against the expected side effects of treatment. In the first hypothetical situation, doctors were presented with a diagnosis of cancer and asked to choose between a treatment that:

• would cure 84% of patients, but leave 4% with complications such as infections and chronic diarrhea, or
• would cure 80% of patients with no complications.

More doctors recommended the first option for their patients than for themselves.

In the second hypothetical, 63% of doctors said they would opt out of a potentially life-saving treatment for avian flu to avoid side effects — but only 49% would advise their patients to do the same.

That’s not to say doctors are giving out bad, or hypocritical, advice to patients. The researchers believe that doctors have a natural bias toward recommending the most logical choice (i.e. the treatment most likely to cure them). But when making their own medical decisions, they’re more likely to consider more emotional issues, such as the effect of long-term complications on quality of life.

That’s according to a new study in the Archives of Internal Medicine. The report notes that of the patients who visited more than one ER, one-third used a variety of hospital ERs.

The study looked at 3.5 million adults in Massachusetts who visited the ER 12.7 million times between 2002 and 2007.

That’s the conclusion of a new study by the Robert Wood Johnson Foundation. The researchers studied 69 million discharge records from 2006 for hospitals in 40 states.

According to the study, patients who developed pneumonia stayed in the hospital an average of 14 extra days. Their increased treatment costs were approximately $46,000 per patient. Of those patients, 11% ultimately died from the infection.

Patients who acquired sepsis stayed in the hospital an extra 11 days, at a cost of an additional $33,000. The infection was fatal for 20% of patients.

The study was published in the Archives of Internal Medicine.

Pros: Better patient care overall. Cons: Docs working longer hours to make the same income.

That’s the result of recent research published in the Archives of Internal Medicine.

The research team collected retrospective data on more than 46,000 visits to primary care doctors by adult patients, between 1997 and 2005. The study showed that the number of visits increased 10% over that period and the average length of a visit increased 16%, from 18 minutes per patient to almost 21 minutes.

Some types of visits increased in duration more than others:

• regular check-ups increased by 3.4 minutes
• high blood pressure checks increased 3.7 minutes
• diabetes diagnoses increased 4.2 minutes, and
• joint disease diagnoses increased 5.9 minutes.

Part of the reason for longer visits is that patients are learning to be more involved in the health care decision-making process, so they come to appointments armed with questions about tests, medications they’ve seen advertised and that tip Aunt Hilda passed on about how eating raw garlic can ward off arthritis.

While few would argue against patients being more engaged in their own care, dealing with those questions does take up valuable clinical time — and like it or not, doctors don’t get paid for their bedside manner. The end result is longer hours for doctors, while total compensation stays the same — if they’re lucky.

What can help

Some practices are instituting smart strategies to free up doctors’ time while still giving patients the time and attention they need and want.

Those strategies include having other staff on hand (physician’s assistant, nurse practitioners, etc.) to handle routine care, as well as group visits, where patients with similar conditions can meet with clinicians to discuss outpatient care and self-management.