Common Medical Decisions often Made without Input from Patients, Study Finds

Discussions between patients and their primary care physicians about some of the most common tests, medications, and procedures do not reflect a high level of shared decision making, according to the results of a study published in the July 8, 2013, issue of JAMA Internal Medicine. The study’s researchers surveyed 2,718 patients age 40 or older who had discussed one or more of 10 common medical decisions with their physicians within the past two years. The decisions were ones that involved beginning a course of medication for hypertension, elevated cholesterol, or depression; diagnostic screening for breast, prostate, or colon cancers; knee or hip replacement surgeries for osteoarthritis, or surgery for cataracts or lower back pain. The study sought to characterize patients’ perceptions of the extent to which their physicians discussed the pros and cons of the decisions and to determine whether the patients were told they had a choice and whether they were asked for their input. The respondents reported much more discussion of the pros than the cons for all tests and treatments.