Annals of Internal Medicine · 1979 · 428 citations · 63 references
Social SciencesPsychiatryPsychologyClinical PsychologyMedical AnthropologyMedical SociologyClinical Decision-makingClinical ReasoningHealth Care Decision-makingPatient-provider RelationshipsShared Decision-makingClinician JudgmentCultural Considerations In Decision-making
Clinical decision-making is shaped not only by quantitative methods but also by sociocultural interactions among clinicians, patients, and the healthcare system, with four key sociologic factors—patient characteristics, clinician characteristics, professional and system interactions, and clinician–patient relationships—affecting judgment. The study investigates how sociologic factors influence clinicians’ decision-making. The authors illustrate these influences by reviewing observations from sociology, clinical psychology, psychiatry, and medicine. Further studies are needed to provide additional empirical information.
Recent articles on clinical decision-making have proposed sophisticated quantitative methods for improving the physician's clinical judgment. Actual clinical decisions, however, are influenced by interactions between the clinician, the patient, and the sociocultural milieu as well as by biomedical considerations. This paper explores these sociologic influences on the decision-making process. Four types of sociologic factors influence the clinician's judgment: the characteristics of the patient; the characteristics of the clinician; the clinician's interaction with his profession and the health care system; and the clinician's relationship with the patient. To illustrate sociologic influences on clinical decision-making, this paper presents observations from the literature of sociology, clinical psychology, psychiatry, and medicine. Further studies are needed to provide additional empirical information.
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Taking Care of the Hateful Patient
James E. Groves · New England Journal of Medicine · 1978 · 733 citations
Stages of Illness and Medical Care
Edward A. Suchman · Journal of Health and Human Behavior · 1965 · 311 citations