Uninformed Patient Choice: The American Way of Making Medical Decisions

Abstract

The model of delegating medical decisions to doctors is alive and well in the U.S. When patients describe interactions with physicians around decisions, they clearly are doctor driven. More importantly, most of the “discussion” is aimed at getting the patient to do something: take a pill, get tested, have surgery, rather than weighing the pros and cons. Doctors are by far the main source of information for patients. Only a minority use the Internet to get information for any particular decision, and even those patients that do say the doctor is more important. However they try to get information, patients end up with very little information about the options they face and basically are in no position to exercise an informed choice. They usually do what doctors recommend. Most physicians report that it would be good if patients had good information. However, doctors do not think highly of the information patients are currently getting, and they report that lack of time and patient ability to understand key information are barriers to their trying to inform patients themselves. Finally, there is a variety of opinions among physicians about whether having patients play an active role in decision making is a good idea.