The impact of a physician’s recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation

Abstract

Objective: This study examined the influence of physicians’ recommendations and gender on the decision-making process in a preference-sensitive situation. Methods: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs. physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision, and attitude toward the treatment options. Then participants watched a video that differed regarding physician’s recommendation (surgery vs. physiotherapy) and physician’s gender (female vs. male voice and picture). Afterward, they indicated again their treatment preference, certainty, satisfaction, and attitude, as well as the physician’s professional and social competence.Results: Participants changed their treatment preferences in the direction of the physician’s recommendation (P<.001). Decision certainty (P<.001) and satisfaction (P<.001) increased more strongly if the physician’s recommendation was congruent with the participant’s prior attitude than if the recommendation was contrary to the participant’s prior attitude. Finally, participants’ attitudes toward the recommended treatment became more positive (surgery recommendation: P<.001; physiotherapy recommendation: P<.001). We found no influence of the physician’s gender on participants’ decisions, attitudes, or competence assessments.Conclusion: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient’s preferences.

Decision aids to prepare patients for shared decision making: Two randomized controlled experiments on the impact of awareness of preference‐sensitivity and personal motives

“…As many patients find it hard to grasp that their personal preferences matter in a medical decision, one way to prepare them for SDM is to explain the concept of preference‐sensitivity better. But even if patients have understood that they themselves and the physician involved should be more sensitive to their personal preferences when medical decisions are made, it is still challenging for them to figure out what is particularly important to them 27,28 . So, for patients who have already understood the preference‐sensitivity of the situation, the next step is to make them aware of potential personal motives in a decision.…”