Despite advances in consumerism in healthcare, physicians continue to hold sway in deciding where their patients will have major elective surgery, according to a survey in the March issue of the Archives of Surgery. While most patients participated in the decision, the survey said, physicians were the main decisionmakers in about one-third of the cases.
Researchers say the study is increasingly relevant as the CMS and private insurers encourage hospitals to become more transparent in providing information about pricing, volume and outcomes at a time when many consumers are taking more active roles in their medical care.
Researchers surveyed 500 Medicare patients in 2004 who had undergone one of five elective high-risk operations about three years earlier. About 42% of the patients said they decided equally with their physicians about where they would have surgery; 31% said the physician was the main decisionmaker; 22% said they primarily made the decision themselves; and 5% said a family member played a leading role.
While many patients participate in the decisionmaking process and may desire objective information to inform their decisions, a substantial proportion of patients are not involved at all, the researchers concluded. Research is needed to help us understand whether patients would like a greater role in deciding where to have major surgery and, if so, how to facilitate such involvement. -- by Michael Romano