Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

Should physicians’ advice be based on patients’ best interests?

Michael Kirsch, MD
Physician
May 10, 2015
Share
Tweet
Share

Do you think that physicians’ advice should be based on their patients’ best interests? How about lawyers? Plumbers? Financial brokers?

An advisor who has what is termed a fiduciary duty is required to use the best interest standard with his client. For example, an attorney is prohibited from recommending that his client proceed to trial, which would be beneficial financially to the lawyer, if the attorney believes that a settlement serves his client’s interest better. While it may not always work this way in the real world, this is how it is supposed to happen.

Shockingly, investment brokers, unlike certified financial planners, have no fiduciary responsibility when advising clients on their personal investments. They are free to make financial recommendations that are “suitable” for a client, even if this would not be in the client’s best interest. The broker can consider his own financial interest, which clearly may conflict with his client’s welfare, without violating any professional standards.

I wonder how many clients of brokers are aware of this scam? The Security and Exchange Commission now has this legalized lapse under review and is expected to issue a regulation later this year, hopefully, raising brokers’ standards to what they should have been all along.

Imagine if all of society operated under these loose rules.

Electrician

Broker standard: Looks like you need a new fixture.

Fiduciary: Looks like you need a new light bulb.

Auto mechanic

Broker standard: The transmission needs to be replaced.

Fiduciary: I think a new spark plug should do it.

Taxi driver

Broker Standard: New in town? Let me show you the sights on our way to your hotel.

Fiduciary: Hop in. We’re only 5 minutes away.

Physician

Broker standard: I think a gastric bypass makes the most sense here.

Fiduciary: I’ve arranged for you to meet with our dietician.

Relax, my patients. Physicians are fiduciaries and are obligated to consider only your best interest, not ours, when we are offering you medical advice. Even if we weren’t true fiduciaries, I’d like to think we’d do the right thing anyway.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

Prev

Why should doctors use Twitter?

May 10, 2015 Kevin 1
…
Next

How can we reduce firearm-related deaths? Here are 6 ways.

May 10, 2015 Kevin 19
…

Tagged as: Primary Care

< Previous Post
Why should doctors use Twitter?
Next Post >
How can we reduce firearm-related deaths? Here are 6 ways.

ADVERTISEMENT

More by Michael Kirsch, MD

  • Are Ozempic patients on a slow-moving runaway train?

    Michael Kirsch, MD
  • AI-driven diagnostics and beyond

    Michael Kirsch, MD
  • The surprising truth behind virtual visits

    Michael Kirsch, MD

More in Physician

  • The true crime community is radicalizing kids online

    Dexter Ingram & Matthew Turner, MD & Stephen Sandelich, MD
  • Navigating medical training and residency as a female plastic surgeon

    Smita Ramanadham, MD
  • 13.1 reasons running a half marathon beats practicing medicine

    John Wei, MD
  • Why experiential consent is replacing traditional medical consent forms

    Ron Tongbai, MD
  • Why career pivots are a valid path in medical training

    Whitney Black, MD
  • Why early detection technology and precision medicine are failing patients

    Julie Chen, MD
  • Most Popular

  • Past Week

    • Medicare practice expense cuts will hurt patients

      John Birkmeyer, MD | Policy
    • When shared decision making gives way to medical paternalism

      DeAnna Pollock, MD | Physician
    • How xenotransplantation could finally solve organ shortages

      Rafael S. Garcia-Cortes, MD | Conditions
    • The human side of medicine in quiet clinical moments

      Devina Maya Wadhwa, MD | Physician
    • Trusting clinical intuition to spot an atypical heart attack

      Anonymous | Physician
    • How rural health care access impacts maternal mortality

      Alyssa Sterner | Policy
  • Past 6 Months

    • Why clinicians fail at writing expert reports

      Tracy Liberatore, Esq, PA | Conditions
    • Rethinking the role of family physicians vs. specialists

      Ronald L. Lindsay, MD | Physician
    • Clinicians are failing at value-based care because no one taught them the system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why clinical listening skills outpace artificial intelligence

      Ryan Egeland, MD, PhD | Tech
    • Why Florida physician background checks are driving doctors away

      Tamzin A. Rosenwasser, MD | Physician
    • The hidden clinical cost of HCC coding in primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The hidden costs of delayed diagnosis and diagnostic ambiguity

      Bita Ghatan | Conditions
    • The true crime community is radicalizing kids online

      Dexter Ingram & Matthew Turner, MD & Stephen Sandelich, MD | Physician
    • Why the doctor-patient relationship survives when trust in public health fails

      Myles Deal, MD | Conditions
    • Navigating medical training and residency as a female plastic surgeon

      Smita Ramanadham, MD | Physician
    • Why cooking for better health makes dietary changes easier

      Oliver Power | Conditions
    • How blood-based brain biomarkers predict Alzheimer’s progression

      Marc Arginteanu, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Medicare practice expense cuts will hurt patients

      John Birkmeyer, MD | Policy
    • When shared decision making gives way to medical paternalism

      DeAnna Pollock, MD | Physician
    • How xenotransplantation could finally solve organ shortages

      Rafael S. Garcia-Cortes, MD | Conditions
    • The human side of medicine in quiet clinical moments

      Devina Maya Wadhwa, MD | Physician
    • Trusting clinical intuition to spot an atypical heart attack

      Anonymous | Physician
    • How rural health care access impacts maternal mortality

      Alyssa Sterner | Policy
  • Past 6 Months

    • Why clinicians fail at writing expert reports

      Tracy Liberatore, Esq, PA | Conditions
    • Rethinking the role of family physicians vs. specialists

      Ronald L. Lindsay, MD | Physician
    • Clinicians are failing at value-based care because no one taught them the system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why clinical listening skills outpace artificial intelligence

      Ryan Egeland, MD, PhD | Tech
    • Why Florida physician background checks are driving doctors away

      Tamzin A. Rosenwasser, MD | Physician
    • The hidden clinical cost of HCC coding in primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The hidden costs of delayed diagnosis and diagnostic ambiguity

      Bita Ghatan | Conditions
    • The true crime community is radicalizing kids online

      Dexter Ingram & Matthew Turner, MD & Stephen Sandelich, MD | Physician
    • Why the doctor-patient relationship survives when trust in public health fails

      Myles Deal, MD | Conditions
    • Navigating medical training and residency as a female plastic surgeon

      Smita Ramanadham, MD | Physician
    • Why cooking for better health makes dietary changes easier

      Oliver Power | Conditions
    • How blood-based brain biomarkers predict Alzheimer’s progression

      Marc Arginteanu, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...