Clinical Decisionmaking

Patient preferences for participating in clinical decisionmaking vary by sex, ethnicity, and age

Physicians are advised to encourage patients to actively participate in medical decisions affecting their care. However, a study supported by the Agency for Healthcare Research and Quality (HS09982) found that while most people want to participate in decisionmaking, at least 50 percent want final decisions to be made by their physicians.

Researchers surveyed 2,765 adults in U.S. households in conjunction with the 2002 General Social Survey and examined associations between respondents' demographics and health status and their preferences for participation in medical decisions. Nearly all respondents (96 percent) preferred to be offered choices and to be asked their opinions; however, 52 percent preferred to leave final decisions to their physicians, and 44 percent preferred to rely on physicians for medical knowledge rather than seeking out information themselves.

Women were more likely than men to prefer a patient-directed, active role in decisionmaking. Blacks and Hispanics were more likely to prefer that physicians make the decisions. Preferences for taking a more active role in decisionmaking increased with age up to 45 years, but then declined.

More details are in "Not all patients want to participate in decision making: A national study of public preferences," by Wendy Levinson, M.D., Audiey Kao, M.D., Ph.D., Alma Kuby, M.B.A., and Ronald A. Thisted, Ph.D., in the June 2005 Journal of General Internal Medicine 20, pp. 531-535.

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