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CMAJ. Aug 15, 1994; 151(4): 423–427.
PMCID: PMC1337094

Physicians in health care management: 8. The patient-physician partnership: decision making, problem solving and the desire to participate.

Abstract

How reasonable are expectations that patients will participate in care decisions? The previous article in this series reviewed models of the patient-physician relationship and views on the extent to which patients want to be informed; it also described one information tool--the interactive videodisc. This article reviews literature on the extent to which patients wish to be involved in making decisions about their care. Neither "sensitive paternalism" nor "informed consent" appears to be ideal. The author suggests a distinction between two elements of choice: problem solving and decision making. This distinction helps in identifying appropriate roles for patient and provider, thereby leading to genuine shared decision making.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Deber RB. Physicians in health care management: 7. The patient-physician partnership: changing roles and the desire for information. CMAJ. 1994 Jul 15;151(2):171–176. [PMC free article] [PubMed]
  • Wennberg JE. Outcomes research, cost containment, and the fear of health care rationing. N Engl J Med. 1990 Oct 25;323(17):1202–1204. [PubMed]
  • Cassileth BR, Zupkis RV, Sutton-Smith K, March V. Information and participation preferences among cancer patients. Ann Intern Med. 1980 Jun;92(6):832–836. [PubMed]
  • Blanchard CG, Labrecque MS, Ruckdeschel JC, Blanchard EB. Information and decision-making preferences of hospitalized adult cancer patients. Soc Sci Med. 1988;27(11):1139–1145. [PubMed]
  • Larsson US, Svärdsudd K, Wedel H, Säljö R. Patient involvement in decision-making in surgical and orthopaedic practice: the Project Perioperative Risk. Soc Sci Med. 1989;28(8):829–835. [PubMed]
  • Strull WM, Lo B, Charles G. Do patients want to participate in medical decision making? JAMA. 1984 Dec 7;252(21):2990–2994. [PubMed]
  • Degner LF, Russell CA. Preferences for treatment control among adults with cancer. Res Nurs Health. 1988 Dec;11(6):367–374. [PubMed]
  • Llewellyn-Thomas HA, McGreal MJ, Thiel EC, Fine S, Erlichman C. Patients' willingness to enter clinical trials: measuring the association with perceived benefit and preference for decision participation. Soc Sci Med. 1991;32(1):35–42. [PubMed]
  • Sutherland HJ, Llewellyn-Thomas HA, Lockwood GA, Tritchler DL, Till JE. Cancer patients: their desire for information and participation in treatment decisions. J R Soc Med. 1989 May;82(5):260–263. [PMC free article] [PubMed]
  • Beisecker AE, Beisecker TD. Patient information-seeking behaviors when communicating with doctors. Med Care. 1990 Jan;28(1):19–28. [PubMed]
  • Ende J, Kazis L, Ash A, Moskowitz MA. Measuring patients' desire for autonomy: decision making and information-seeking preferences among medical patients. J Gen Intern Med. 1989 Jan-Feb;4(1):23–30. [PubMed]
  • Brody DS, Miller SM, Lerman CE, Smith DG, Lazaro CG, Blum MJ. The relationship between patients' satisfaction with their physicians and perceptions about interventions they desired and received. Med Care. 1989 Nov;27(11):1027–1035. [PubMed]
  • Siminoff LA, Fetting JH. Factors affecting treatment decisions for a life-threatening illness: the case of medical treatment of breast cancer. Soc Sci Med. 1991;32(7):813–818. [PubMed]
  • Wartman SA, Morlock LL, Malitz FE, Palm EA. Patient understanding and satisfaction as predictors of compliance. Med Care. 1983 Sep;21(9):886–891. [PubMed]
  • Weiss GB. Paternalism modernised. J Med Ethics. 1985 Dec;11(4):184–187. [PMC free article] [PubMed]
  • Waterworth S, Luker KA. Reluctant collaborators: do patients want to be involved in decisions concerning care? J Adv Nurs. 1990 Aug;15(8):971–976. [PubMed]
  • Lidz CW, Meisel A, Osterweis M, Holden JL, Marx JH, Munetz MR. Barriers to informed consent. Ann Intern Med. 1983 Oct;99(4):539–543. [PubMed]
  • Wade TC. Patients may not recall disclosure of risk of death: implications for informed consent. Med Sci Law. 1990 Jul;30(3):259–262. [PubMed]
  • McNeil BJ, Weichselbaum R, Pauker SG. Fallacy of the five-year survival in lung cancer. N Engl J Med. 1978 Dec 21;299(25):1397–1401. [PubMed]
  • Barry MJ, Mulley AG, Jr, Fowler FJ, Wennberg JW. Watchful waiting vs immediate transurethral resection for symptomatic prostatism. The importance of patients' preferences. JAMA. 1988 May 27;259(20):3010–3017. [PubMed]
  • Fowler FJ, Jr, Wennberg JE, Timothy RP, Barry MJ, Mulley AG, Jr, Hanley D. Symptom status and quality of life following prostatectomy. JAMA. 1988 May 27;259(20):3018–3022. [PubMed]
  • Kassirer JP. Adding insult to injury. Usurping patients' prerogatives. N Engl J Med. 1983 Apr 14;308(15):898–901. [PubMed]

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