Sharing health decisions not always positive

NEW YORK (Reuters Health) - Shared decision-making between patients and their doctors is frequently rated as a negative experience by patients, according to the results of a small study appearing in the Annals of Family Medicine.

Proponents of shared decision-making believe that it makes medical visits more satisfying for both doctor and patient than does a one-sided decision-making style. Yet, data on the actual benefits that shared decision-making provides is limited.

Dr. George W. Saba, from the University of California at San Francisco, and colleagues analyzed the decision-making that occurred in primary care office visits made by 18 patients.

A total of 125 decisions were made during the 18 visits. Of these, 62 involved shared decision-making, the report indicates.

When the team further analyzed the decision process, they found that the patient was not really engaged in 40 percent of them. Also, the patients rated the experience as negative in 57 percent of instances.

Trust, power, and other relationship factors as well as communication behavior seemed to influence the subjective experience of the patient-physician partnership.

"Efforts to enhance patient-physician communication, especially among disadvantaged populations, must include both effective communication behavior and affective relationship dynamics," the authors emphasize.

SOURCE: Annals of Family Medicine, January/February 2006.