Use of deceptive tactics in physician practices: are there differences between international and US medical...

Concerns have been raised about the medical practices of international medical graduates (IMGs) in the United States. This study examined the differences between IMGs and US-trained medical graduates (USMGs) in their attitude toward and utilization of deception in medical practices. A random sample of physicians practicing in the US was surveyed by mail in 1998. The dependent variables of interest included 11 attitudinal and behavioral indicators of deceptive tactics in medical practice. IMGs and USMGs displayed limited difference in their attitudes but some differences in their self-reported use of deceptive tactics in medical practice. IMGs were less likely than USMGs to change the patient's official diagnosis (OR, 0.557; 95% CI, 0.344-0.902) or to withhold a useful service because of utilization rules (OR, 0.612; 95% CI, 0.382-0.979). The hypothesis that IMGs have less appropriate professional standards than USMGs is not supported by this study. Alternative hypotheses, such as IMG familiarity with US health care and legal systems, warrant investigation.