Doc specialty can create potential for bias, result in poor decision-making

Physician xray

Patients trust physicians who are up front with them about biases related to their specialties, but according to a recent study published in the Proceedings of the National Academy of Sciences, that’s not necessarily a good thing when it comes to shared decision-making.

As FiercePracticeManagement has reported, effective shared decision-making generally demands that physicians provide as much information as possible for patients to make an informed decision about their care, which means taking time to answer questions openly and resist making recommendations. The specialty bias study notes the relative ubiquity of policies requiring disclosure of conflicts of interest in a range of industries, and the link between such disclosures and increased consumer trust.

The study had surgeons plainly disclose their potential treatment bias by telling patients, “Remember, I am a surgeon, so I know more about surgery than radiation.” Among patients who received this disclosure, however, 74 percent indicated they were more likely to choose surgery, as opposed to 64.7 percent in a control group. In other words, when it comes to a healthcare setting, this particular increase in trust has an unintended consequence: patients become more likely to pursue a treatment because they trust their doctor, even though that increased trust gets generated when the doctor discloses a bias toward that treatment.

“If an adviser discloses a bias, it should alert the recipient to some uncertainty regarding the quality of the advice,” said Sunita Sah, Ph.D., of the Johnson Graduate School of Business at Cornell University and one of the study’s authors, in an article in MedicalXpress. Since their research shows this not to be the case, the authors recommend increased education around the subject for both patients and physicians.

Sah also suggested that physicians and policymakers take a close look at the way such disclosures get made, in order to avoid influencing patient decisions unduly.

- here’s the study
- read the article