To avoid 'difficult' label, patients take passive role in care decisions

In a step backwards for shared decision-making, many patients surrender their authority to physicians because they fear being labeled "difficult," concludes a study from the Palo Alto (Calif.) Medical Foundation Research Institute.

Despite calls for patient-centered care, 48 Bay Area patients said they held back from challenging their physicians or asking questions, worried that such actions would lead to inferior care or a damaged relationship, the San Francisco Chronicle reported.  

"What's interesting to us is these were mostly Caucasian, highly educated, well-to-do people, and they're talking about these difficulties," lead author Dominick Frosch, an associate investigator at the Palo Alto Medical Foundation Research Institute, told the Chronicle. "It's difficult to imagine this is easier for people in a less advantageous social position."

The study findings are problematic, according to researchers, as passivity prevents patients from being well-informed and fully engaged in their own health.

But physician-patient relationships are a two-way street. In fact, a study published last February in the Journal of General Internal Medicine found that physician traits may play a significant role in creating challenging patient encounters. According to physician-completed assessments, physicians who reported difficult encounters--and the accompanying poor outcomes--tended to have less experience and poorer psychosocial orientation than their less-troubled colleagues, FiercePracticeManagement previously reported.

To learn more:
- here's the study abstract from the Palo Alto Medical Foundation Research Institute
- read the San Francisco Chronicle article
- here's the study abstract from the Journal of General Internal Medicine

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