The Application Paper
The article selected in this case was that written by McKinlay et al. titled “The Unexpected Influence of Physician Attributes On Clinical Decisions: Results of An Experiment.” Over the years, there have been numerous social problems that hamper service delivery in healthcare settings. Some of these problems include poor relationship between healthcare experts and patients, the lack of support from social organizations, and resistance from society. In this article, the social problem in the healthcare context being investigated by the researchers is the unexpected influence of physician attributes on clinical decision-making. The researchers’ focus is on whether attributes or characteristics of physicians including gender, age, medical specialty, and age, have a significant influence on how medical decisions are made.
The research uses an experimental design to determine whether physician attributes or characteristics indeed have an influence on clinical decision-making. The experiment involves randomly assigning 16 videotapes that portray encounters between patients and physicians for two specific medical conditions, which are polymyalgia rheumatica (PMR) and depression, to physicians for examination. Each of the scenarios portraying patient-physician encounters (PMR and depression) are taped repeatedly while varying patient attributes such as age, gender, socioeconomic status, and race. The videotapes are then presented to sampled 128 physicians who are also classified based on attributes such as race, medical specialty, experience, and gender. Once each physician has viewed a variant of each scenario, they are then questioned on perspectives such as treatment, diagnosis, medication, and referral for the patients who are portrayed in the videotapes. Also, the experimental design involves the use of questionnaire where the sampled physicians are asked to answer specific questions aimed at measuring how aspects such as race, age, and gender, influenced their decision on the patients portrayed in the videos. The experiment was carried out at practice workplaces of the sampled physicians during regular hours by a trained interviewer. Given the busy schedule of the physicians, they were reimbursed $100 to offset the revenue lost during the time set aside for the experiment (McKinlay et al., 2002).
During the experiment, patients portrayed in the videos presented different attributes or characteristics such as age, gender, socioeconomic status, and race. In this case, the focus was on determining whether patient attributes influence physician decision-making where it was found that patient attributes do not influence physician decision-making. With the primary focus on whether physician attributes or characteristics influence physician decision-making, it was found that characteristics of physicians such as medical specialty, age, and race, had an interactive influence on medical decision-making. For instance, during the experiment, the influence of physician age on clinical decision-making was evident in the fact that older physicians exhibited lower test ordering whereas younger physicians showed markedly higher test ordering (McKinlay et al., 2002).
An important deduction from the experiment is that key patient attributes such as age, gender, and socioeconomic status ought to have an influence on clinical or physician decision-making (Restivo et al., 2016). However, these decisions must not be influenced by physician attributes or characteristics. Therefore, it is mandatory for physicians and other health experts to make appropriate medical decisions that are not influenced by physician attributes. A solution to this social problem is closely examining doctor-patient relationships in healthcare contexts to determine whether physician characteristics have a negative influence on these relationships. Moreover, training of physicians on the need to avoid patient interactions influenced by age, race, and medical specialty would help address the social problem.
McKinlay, J. B., Lin, T., Freund, K., & Moskowitz, M. (2002). The unexpected influence of physician attributes on clinical decisions: results of an experiment. Journal of Health and Social Behavior, 43(1), 92. Retrieved from http://www.aleciashepherd.com/writings/articles/other/The%20Unexpected%20Influence%20of%20Physician%20Attributes%20on%20Clinical.pdf
Restivo, L., Apostolidis, T., Bouhnik, A. D., Garciaz, S., Aurran, T., & Julian-Reynier, C. (2016). Patients’ Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings. PloS one, 11(5), e0154969. Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154969
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