Authoritarian physicians and patients' fear of being labeled 'difficult' among key obstacles to shared decision making

Health Affairs

Volumn 31, Issue 5, 2012, Pages 1030-1038

  Frosch, Dominick L ^a,b   May, Suepattra G ^a   Rendle, Katharine A S ^a   Tietbohl, Caroline ^a   Elwyn, Glyn ^c  

^a PALO ALTO MEDICAL FOUNDATION RESEARCH INSTITUTE   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c DARTMOUTH INSTITUTE FOR HEALTH POLICY AND CLINICAL PRACTICE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; AUTHORITARIAN PHYSICIAN; AUTHORITY; CONSULTATION; CONTROLLED STUDY; DECISION MAKING; EDUCATIONAL STATUS; FEAR; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; PATIENT PARTICIPATION; PHYSICIAN; SHARED DECISION MAKING; SOCIAL SUPPORT; UNITED STATES;

AGED; AUTHORITARIANISM; DECISION MAKING; FEAR; FEMALE; FOCUS GROUPS; HUMANS; MALE; MIDDLE AGED; PATIENT PARTICIPATION; PHYSICIAN-PATIENT RELATIONS; SAN FRANCISCO;

EID: 84862497603     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2011.0576     Document Type: Article

References (44)

1. Brody DS. The patient's role in clinical decision-making. Ann Intern Med. 1980;93(5):718-22.
2. Katz J. The silent world of doctor and patient. Baltimore (MD): Johns Hopkins University Press; 2002.
3. Wennberg JE, O'Connor AM, Collins ED, Weinstein JN. Extending the P4P agenda, part 1: how Medicare can improve patient decision making and reduce unnecessary care. Health Aff (Millwood). 2007;26(6): 1564-74.
4. Bennett K, Smith DH, Irwin H. Preferences for participation in medical decision in China. Health Commun. 1999;11(3):261-84.
5. Cullati S, Courvoisier DS, Charvet-Bérard AI, Perneger TV. Desire for autonomy in health care decisions: a general population survey. Patient Educ Couns. 2011;83(1):134-8.
6. Davey HM, Lim J, Butow PN, Barratt AL, Redman S. Women's preferences for and views on decision-making for diagnostic tests. Soc Sci Med. 2004;58(9):1699-707.
7. Leino-Kilpi H, Välimäki M, Dassen T, Gasull M, Lemonidou C, Scott PA, et al. Perceptions of autonomy, privacy, and informed consent in the care of elderly people in five European countries: comparison and implications for the future. Nurs Ethics. 2003;10(1):58-66.
8. Levinson W, Kao A, Kuby A, Thisted RA. Not all patients want to participate in decision making: a national study of public preferences. J Gen Intern Med. 2005;20(6):531-5.
9. Campion P, Foulkes J, Neighbour R, Tate P. Patient centredness in the MRCGP video examination: analysis of large cohort. BMJ. 2002; 325(7366):691-2.
10. Braddock CH 3rd, Edwards KA, HasenbergNM, Laidley TL, Levinson W. Informed decision making in outpatient practice: time to get back to basics. JAMA. 1999;282(24): 2313-20.
11. Hoffman RM, Lewis CL, Pignone MP, Couper MP, Barry MJ, Elmore JG, et al. Decision-making processes for breast, colorectal, and prostate cancer screening: the DECISIONS Survey. Med Decis Making. 2010; 30(5): 53S-64S.
12. Zikmund-Fisher BJ, Couper MP, Singer E, Ubel PA, Ziniel S, Fowler FJ Jr., et al. Deficits and variations in patients' experience with making 9 common medical decisions: the DECISIONS Survey. Med Decis Making. 2010;30(5):85S-95S.
13. Brackett C, Kearing S, Cochran N, Tosteson AN, Blair Brooks W. Strategies for distributing cancer screening decision aids in primary care. Patient Educ Couns. 2010;78(2): 166-8.
14. Caldon LJ, Collins KA, Reed MW, Sivell S, Austoker J, Clements AM, et al. Clinicians' concerns about decision support interventions for patients facing breast cancer surgery options: understanding the challenge of implementing shared decision-making. Health Expect. 2011; 14(2):133-46.
15. Frosch DL, Singer KJ, Timmermans S. Conducting implementation research in community-based primary care: a qualitative study on integrating patient decision support interventions for cancer screening into routine practice. Health Expect. 2011;14(Suppl 1):73-84.
16. Légaré F, O'Connor AM, Graham ID, Saucier D, Côté L, Blais J, et al. Primary health care professionals' views on barriers and facilitators to the implementation of the Ottawa Decision Support Framework in practice. Patient Educ Couns. 2006;63(3):380-90.
17. Légaré F, Ratté S, Gravel K, Graham ID. Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals' perceptions. Patient Educ Couns. 2008;73(3):526-35.
18. Elwyn G, Edwards A, Gwyn R, Grol R. Towards a feasible model for shared decision making: focus group study with general practice registrars. BMJ. 1999;319(7212):753-6.
19. Elwyn G, Edwards A, Kinnersley P, Grol R. Shared decision making and the concept of equipoise: the competences of involving patients in healthcare choices. Br J Gen Pract. 2000;50(460):892-9.
20. Elwyn G, Edwards A, Wensing M, Hibbs R, Wilkinson C, Grol R. Shared decision making observed in clinical practice: visual displays of communication sequence and patterns. J Eval Clin Pract. 2001;7(2):211-21.
21. Towle A, Godolphin W. Framework for teaching and learning informed shared decision making. BMJ. 1999;319(7212):766-71.
22. Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, et al. How to do shared decision making: a model for clinical practice. J Gen Intern Med. Forthcoming.
23. Kaplan RM, Frosch DL. Decision making in medicine and health care. Annu Rev Clin Psychol. 2005;1: 525-56.
24. Frosch DL, Légaré F, Fishbein M, Elwyn G. Adjuncts or adversaries to shared decision-making? Applying the Integrative Model of Behavior to the role and design of decision support interventions in healthcare interactions. Implement Sci. 2009; 4:73.
25. Entwistle VA, McCaughan D, Watt IS, Birks Y, Hall J, Peat M, et al. Speaking up about safety concerns: multi-setting qualitative study of patients' views and experiences. Qual Saf Health Care. 2010;19(6): e33.
26. Kinnersley P, Edwards A, Hood K, Ryan R, Prout H, Cadbury N, et al. Interventions before consultations to help patients address their infor-mation needs by encouraging question asking: systematic review. BMJ. 2008;337:a485.
27. Wennberg JE, Fisher ES, Skinner JS. Geography and the debate over Medicare reform. Health Aff (Millwood). 2002;21:w96-114. DOI: 10.1377/hlthaff.w2.96.
28. Fishbein M, Ajzen I. Predicting and changing behavior: the reasoned action approach. New York (NY): Psychology Press; 2010.
29. Fishbein M. The role of theory in HIV prevention. AIDS Care. 2000; 12(3):273-8.
30. Makoul G, Clayman ML. An integrative model of shared decision making in medical encounters. Patient Educ Couns. 2006;60(3): 301-12.
31. To access the Appendix, click on the Appendix link in the box to the right of the article online
32. Glaser BG. The constant comparative method of qualitative analysis. Social Problems. 1965;12(4):436-45.
33. Although only forty-eight patients attended the focus groups, some respondents are identified with numbers higher than forty-eight. Up to twelve identification numbers we predetermined for each focus group, and participants were assigned to available number slots as they were scheduled for each group. The twelve participant identification numbers that exceed the actual number of participants can be accounted for as follows: Four participants canceled enrollment in the study prior to the focus group date, four participants did not show up for their scheduled focus group, and four participants were rescheduled and reassigned to a new number. Identification slots for participants who canceled or did not show up were not reassigned.
34. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997;44(5):681-92.
35. Charles C, Whelan T, Gafni A. What do we mean by partnership in making decisions about treatment? BMJ. 1999;319(7212):780-2.
36. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med. 1999;49(5):651-61.
37. Tuckett D, Boulton M, Olson C, Williams A. Meeting between experts: an approach to sharing ideas in medical consultations. London: Tavistock Publications; 1985.
38. Berwick DM. What 'patient-centered' should mean: confessions of an extremist. Health Aff (Millwood). 2009;28(4):w555-65. DOI: 10.1377/ hlthaff.28.4.w555.
39. Barry MJ. The prostate cancer treatment bazaar: comment on 'physician visits prior to treatment for clinically localized prostate cancer.' Arch Intern Med. 2010; 170(5):450-2.
40. O'Connor AM, Bennett CL, Stacey D, Barry M, Col NF, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2009;(3):CD001431.
41. Elwyn G, Frosch D, Volandes AE, Edwards A, Montori VM. Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions. Med Decis Making. 2010;30(6):701-11.
42. Reid RJ, Coleman K, Johnson EA, Fishman PA, Hsu C, Soman MP. The group health medical home at year two: cost savings, higher patient satisfaction, and less burnout for providers. Health Aff (Millwood). 2010;29(5):835-43.
43. Fowler FJ Jr., Levin CA, Sepucha KR. Informing and involving patients to improve the quality of medical decisions. Health Aff (Millwood). 2011;30(4):699-706.
44. Frosch DL, Elwyn G. I believe, therefore I do. J Gen Intern Med. 2011;26(1):2-4