The impact of physicians’ recommendations on treatment preference and attitudes: a randomized controlled experiment on shared decision-making

ABSTRACT

Making decisions based on their own evaluation of relevant information and beliefs is very challenging for patients. Many patients feel that they lack the knowledge to make a decision and expect a recommendation by their physician. We conducted an experimental study to examine the impact of physicians’ recommendations on the decision-making process. N = 194 medical laypeople were placed in a hypothetical scenario where they suffered from a cruciate ligament rupture and were faced with the decision about a treatment (surgery or physiotherapy). In a 3 × 2 between-group design we investigated the impact of physicians’ recommendations (for surgery, for physiotherapy, no recommendation) and reasoning style (scientific, narrative) on treatment preference, certainty and satisfaction regarding treatment preference, and attitudes. We found that the recommendation had a significant influence on treatment preference and attitudes toward both treatments. Additionally, we found a significant increase in certainty and satisfaction after the intervention, independently of whether they received a recommendation. This finding suggested that a recommendation was not required to strengthen participants’ confidence in their decision. There were no effects of reasoning style. We discuss the implications and suggest that physicians should be careful with recommendations in situations in which patients’ preferences are important.

KEYWORDS:

• Shared decision making
• physicians’ recommendations
• patient preferences
• patient-physician communication

Acknowledgments

We confirm that all personal identifiers have been removed so the persons described are not identifiable and cannot be identified through any details of the studies.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

The research reported here was performed in accordance with the Declaration of Helsinki and had full approval by the ethics committee of the Leibniz-Institut fuer Wissensmedien (approval number: LEK 2017/041).

Additional information

Funding

The research reported here was funded by funded by the Leibniz ScienceCampus Cognitive Interfaces