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

Abstract

ABSTRACTMaking 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.