Choosing Doctors Wisely: Can Assisted Choice Enhance Patients' Selection of Clinicians?

Med Care Res Rev. 2019 Oct;76(5):572-596. doi: 10.1177/1077558717743822. Epub 2017 Nov 25.

Abstract

We conducted a simulated clinician-choice experiment, comparing choices and decision-making processes of participants (N = 688) randomized among four experimental arms: a conventional website reporting only quantitative performance information, a website reporting both qualitative (patient comments) and quantitative information, the second website augmented by a decision aid (labeling of patient comments), and the decision-aided website further augmented by the presence of a trained navigator. Introducing patient comments enhanced engagement with the quality information but led to a decline in decision quality, particularly the consistency of choices with consumers' stated preferences. Labeling comments helped erase the decline in decision quality, although the highest percentage of preference-congruent choices was seen in the navigator arm. Engagement with the quality information and satisfaction with choices available were likewise highest in the navigator arm. Findings held for high- and low-skilled decision makers. Thus, navigator assistance may be a promising strategy for equitably promoting higher quality choices in information-rich contexts.

Keywords: clinician choice; decision aids; decision navigators; doctor choice; patient navigators.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Choice Behavior*
  • Clinical Competence / standards*
  • Consumer Behavior*
  • Decision Making*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Participation*
  • Physician-Patient Relations
  • Young Adult