Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • 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

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.

ADVERTISEMENT

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

Post navigation

< 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

  • Why DPC market-model fit matters most

    Dana Y. Lujan, MBA
  • The quiet will of a healer

    Ashwini Nadkarni, MD
  • Clear communication is kind patient care

    Mary Remón, LCPC & Tiffany Troso-Sandoval, MD
  • What is professional inertia in medicine?

    Ronald L. Lindsay, MD
  • The rise of digital therapeutics in medicine

    Muhamad Aly Rifai, MD
  • Paraphimosis and diabetes: the hidden link

    Shirisha Kamidi, MD
  • Most Popular

  • Past Week

    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • Systematic neglect of mental health

      Ronke Lawal | Tech
    • The difference between a doctor and a physician

      Mick Connors, MD | Physician
    • Silicon Valley’s primary care doctor shortage

      George F. Smith, MD | Physician
    • Understanding post-vaccination syndrome in real-world medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • The courage to choose restraint in medicine

      Kelly Dórea França | Education
  • Past 6 Months

    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • A doctor’s letter from a federal prison

      L. Joseph Parker, MD | Physician
    • The stoic cure for modern anxiety

      Osmund Agbo, MD | Physician
    • A cancer doctor’s warning about the future of medicine

      Banu Symington, MD | Physician
  • Recent Posts

    • Understanding post-vaccination syndrome in real-world medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why DPC market-model fit matters most

      Dana Y. Lujan, MBA | Physician
    • The quiet will of a healer

      Ashwini Nadkarni, MD | Physician
    • Clear communication is kind patient care

      Mary Remón, LCPC & Tiffany Troso-Sandoval, MD | Physician
    • Helping children overcome anxiety [PODCAST]

      The Podcast by KevinMD | Podcast
    • Can flu shots prevent heart attacks?

      Larry Kaskel, 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

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • Systematic neglect of mental health

      Ronke Lawal | Tech
    • The difference between a doctor and a physician

      Mick Connors, MD | Physician
    • Silicon Valley’s primary care doctor shortage

      George F. Smith, MD | Physician
    • Understanding post-vaccination syndrome in real-world medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • The courage to choose restraint in medicine

      Kelly Dórea França | Education
  • Past 6 Months

    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • A doctor’s letter from a federal prison

      L. Joseph Parker, MD | Physician
    • The stoic cure for modern anxiety

      Osmund Agbo, MD | Physician
    • A cancer doctor’s warning about the future of medicine

      Banu Symington, MD | Physician
  • Recent Posts

    • Understanding post-vaccination syndrome in real-world medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why DPC market-model fit matters most

      Dana Y. Lujan, MBA | Physician
    • The quiet will of a healer

      Ashwini Nadkarni, MD | Physician
    • Clear communication is kind patient care

      Mary Remón, LCPC & Tiffany Troso-Sandoval, MD | Physician
    • Helping children overcome anxiety [PODCAST]

      The Podcast by KevinMD | Podcast
    • Can flu shots prevent heart attacks?

      Larry Kaskel, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • 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...