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Doctors don’t follow guidelines even when they’re the patient

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Doctors don’t follow guidelines even when they’re the patient

Doctors and their close relatives are less likely to adhere to medication guidelines, including those covering antibiotics, than their patients. 

Researchers at the Massachusetts Institute of Technology (MIT) used Swedish data to study adherence to 63 medication-related guidelines (e.g. covering antibiotics, the elderly and drugs for specific indications) by 5,887,471 people. Of these, 149,399 were doctors or their partners, parents and children. 

On average, patients adhered to guidelines 54.4 per cent of the time. A demographically similar group of doctors and their families lagged a statistically significant 3.8 per cent behind (50.6 per cent).

Doctors and their families followed 41 guidelines less often than the rest of the population with the difference statistically significant for 20 guidelines. Doctors and their families followed 22 guidelines more often than the rest of the population (significant for three guidelines). 

Doctors were 8.4 per cent less likely to follow guidelines when taking medication themselves, with the difference in guideline adherence most marked for antibiotics. 

“There is a lot of concern that people don’t understand guidelines, that they are too complex to follow, that people don’t trust their doctors,” says study author Professor Amy Finkelstein from MIT’s department of economics. 

“If that is the case, you should see the most adherence when you look at patients who are physicians or their close relatives. We were struck to find that the opposite holds, that physicians and their close relatives are less likely to adhere to their own medication guidelines.” (American Economic Review: Insights
2022: 4:507-526)

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