Physicians being deceived
Physicians being deceived
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DOI：
10.1111/j.1526-4637.2007.00315.x
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发表时间：
2007-07-01
期刊：
影响因子：
3.1
通讯作者：
Reidenberg, Marcus M.
中科院分区：
文献类型：
--
作者：
Jung, Beth;Reidenberg, Marcus M.
Objective.在几起针对医生开阿片类药物的高调起诉中，检察官声称医生应该知道这些人假装疼痛只是为了获得处方。这项研究是为了确定如何容易医生可以告诉病人说谎。对用于评价医生实践的标准化患者的研究进行了文献检索。标准化患者是被教导模仿患有特定疾病的患者的演员。然后对这些论文进行回顾，以了解医生正确识别标准化（撒谎）患者的门诊频率。六项使用标准化患者的执业医生研究报告了这些行为者被确定为标准化患者的频率。这种情况大约发生在10%的时间。部分真实的患者被错误地认定为行为者。欺骗是很难察觉的。在目前围绕阿片类药物处方的法律的气候下，接受患者表面上的疼痛报告可能会对医生产生重大的法律的后果。虽然医生必须尽一切合理的努力来确认诊断和阿片类药物治疗的需要，但必须考虑到认真的医生可能会被欺骗。
Objective. In several high profile prosecutions of physicians for prescribing opioids, prosecutors claimed that the doctors should have known the individuals were feigning pain solely to obtain the prescriptions. This study was to determine how readily physicians can tell that patients lie.Methods. A literature search was done for studies of standardized patients used to evaluate physicians' practices. Standardized patients are actors taught to mimic a patient with a specific illness. The papers were then reviewed for the frequency with which the physician correctly identified which office visits were by the standardized (lying) patients.Results. Six studies of practicing physicians using standardized patients reported the frequency with which these actors were identified as the standardized patients. This occurred around 10% of the time. Some real patients were erroneously identified as the actors.Conclusion. Deception is difficult to detect. In the current legal climate surrounding prescribing opioids, accepting patients' reports of pain at face value can have significant legal consequences for the doctor. While doctors must make every reasonable effort to confirm the diagnosis and need for opioid therapy, allowance must be made for the fact that conscientious doctors can be deceived.