Do Doctors Have Biases?
Like all people, doctors have all sorts of biases –- some of which they are aware and some of which they are not. For the purposes of this discussion, we’re going to focus on one specific bias that can play a big role when you are trying to decide on an initial treatment for prostate cancer.
The Specialty-Specific Bias That Nearly All Doctors Have
Nearly all doctors have a bias favoring their own specialty. They may not necessarily be personally happy practicing in their specialty, but they are convinced of their specialty’s superiority in terms of patient care. In the United States, graduating medical students choose the field of medicine they would like to enter and then spend the next three to seven years training in that field before entering the wider world.
For instance, both urologists (who perform the vast majority of radical prostatectomies in the United States) and radiation oncologists (who plan and implement the radiation treatments for prostate cancer) are physicians who had to complete at least five years of residency training in their own specialty.
Both during and after training, physicians are mostly surrounded by information related to their own specialty. Urologists read urology journals, conduct clinical research related to urology, perform urological surgeries, and go to conferences with other urologists. Roughly the same goes for radiation oncologists.
Obviously then, urologists know more about urology and urological surgery than they know about any other field of medicine and radiation oncologists know more about radiation therapy than they know about any other field.
How Does This Bias Affect You As a Patient?
When you sit down to talk with an urologist or a radiation oncologist about your treatment options, they are going to explain what they know best -– their field of specialization. They are also going to recommend the treatment option that they are most comfortable with -- and this is almost always going to be their treatment option.
Urologists are, more often than not, going to recommend radical prostatectomy as the best treatment option for early stage prostate cancer and radiation oncologists, more often than not, are going to recommend radiation therapy. This is not because they are being dishonest or trying to drum up business (hopefully at least). It is because they are far more comfortable recommending something that they know a great deal about and are less comfortable advising you to go a route about which they know comparatively less.
The Bottom Line
When faced with a new diagnosis of prostate cancer, it can be extremely tempting to rush ahead and choose a treatment option so that no time is wasted while the cancer continues to grow. While expediency is definitely a virtue in this situation, any man faced with a diagnosis of early prostate cancer owes it to himself to carefully evaluate both surgery and radiation therapy before choosing.
Besides doing your own independent research on the pros and cons of these two treatment options, it is extremely important to talk with both an urologist and a radiation oncologist about your options. Only after speaking with each of these specialists (while keeping in mind their specialty-specific bias) can a fully-informed decision be made.