Saturday Quirk - Non-Participative Management

Robert W. Griffith, MD

In a former life I worked in an organization that placed great value on a management technique called " Participative Management". In a nutshell, the concept involved the boss collecting informed input from all his immediate underlings, and then making a well-informed decision, after hearing all sides of the argument. I was reminded of this when I read a report in the Annals of Behavioral Medicine.

Apparently, not all patients want an active role in their healthcare and medical decision-making. Dr Christensen of Iowa City surveyed 16 primary care physicians and 146 of their patients. Both the doctors and the patients completed two measures of attitudes to their healthcare. This allowed the patient-physician couples into three groups: asymmetrical couples, where the patients were less patient-centered than their physicians; asymmetrical couples where the patients were more patient-centered than their physicians, and symmetrical couples. The patients also completed reports on their satisfaction with their present physician and their healthcare. Patients who were less patient-centered than their physician (the first group) were significantly less satisfied with their physician and their care than those from the symmetrical and the other asymmetrical group.

These result - though a bit hard to understand at first - suggest that, when patients don't want an active role but their physicians want to involve them more in decision-making, the patients are significantly less satisfied with their doctor-patient relationship. In other words, there are some patients who want to leave all the decisions to the doctor, i.e. no participation. It would be a good thing if such people let their doctor know in advance of their attitude, to avoid mutual frustration.

Source
HealthandAge Blog

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