Author Affiliations: Division of Gastroenterology and Hepatology, and Center for Behavioral and Decision Sciences in Medicine, University of Michigan Health System, Ann Arbor (Dr Volk); and Fuqua School of Business, Duke University, Durham, North Carolina (Dr Ubel).
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!
Volk ML, Ubel PA. Ignorance Is Bliss?—Reply. Arch Intern Med. 2011;171(17):1600–1601. doi:10.1001/archinternmed.2011.429
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