Physician-patient psychosocial characteristics influencing medical decision-making

Abstract

This study explores certain physician-patient psychosocial characteristics influencing medical decision-making about length of hospitalization and discharge medications in the hospitalized treatment of patients with chronic asthma. The physician's personal orientation toward the treatment of patients was operationalized as low or high physician sensitivity. Briefly, high sensitivity physicians treat their patients as whole persons while low sensitivity physicians treat them as instances of pulmonary pathology. Significant differences were observed between low and high sensitivity physicians in the number of discharge medications they wrote for both asthma and nonasthma medications and in the length of hospitalization of their patients. The patient's mode of coping with the illness was operationalized as low, moderate, or high levels of panic-fear symptomatology. Low panic-fear scores are characteristics of patients who tend to minimize their symptoms while high panic-fear scores are characteristics of patients who tend to emphasize their symptoms. Patients with extreme low or high panic-fear levels were reacted to quite differently by low and high sensitivity physicians. This affected decisions about discharge medications and length of hospitalization. In short, high sensitivity physicians prescribed less steroid medications to extreme low and high panic-fear patient groups and hospitalized them longer relative to the moderate panic-fear group. By comparison, low sensitivity physicians prescribed more steroid medications to the extreme patient groups and hospitalized them for shorter durations. A comprehensive and detailed understanding of the influences of physician characteristics on medical decision-making will require additional studies to assess specific individual differences in perceptual, cognitive, and affective capacities.