Why Do Patients Derogate Physicians Who Use a Computer-Based Diagnostic Support System?

Shaffer, Victoria A.; Probst, C. Adam; Merkle, Edgar C.; Arkes, Hal R.; Medow, Mitchell A.

doi:10.1177/0272989x12453501

Cited by 83 publications

(62 citation statements)

References 20 publications

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“…Instrumentality should influence perceptions of physicians' self-focused emotion, such that they seem more empty, while also increasing preference for physicians who are patient focused and attend to patients' emotions. Consistent with this prediction, patients notice how caring their physicians are to them (Epstein, 2006;Mercado et al, 2012), respond more favorably to physicians who express affect toward patients (Beck, Daughtridge, & Sloane, 2002), derogate physicians who use impersonal decision aids (Arkes, Shaffer, & Medow, 2007;Shaffer, Probst, Merkle, Arkes, & Medow, 2012), and trust physicians based on their patient-focused affective characteristics (Sims, Tsai, Koopman-Holm, Thomas, & Goldstein, 2014). Specifically with respect to different types of emotions, we predict that when physicians are more instrumental, people will perceive them to have less self-focused (but not patientfocused) emotions and will prefer physicians who have more patient-focused (but not self-focused) emotions.…”

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confidence: 95%

The “Empty Vessel” Physician

Schroeder

Fishbach

2015

Social Psychological and Personality Science

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Although much research examines how physicians perceive their patients, here we study how patients perceive physicians. We propose patients consider their physicians like personally emotionless ''empty vessels'': The higher is individuals' need for care, the less they value physicians' traits related to their personal lives (e.g., self-focused emotions), but the more they value physicians' traits related to patients (e.g., patient-focused emotions). In an initial study, participants recalled fewer personal facts (e.g., marital status) about physicians who seemed more important to their health. In subsequent experiments, participants in higher need for care believed physicians have less personal emotions. Although higher need individuals, such as patients in a clinic, perceived their physicians to be personally emotionless, they wanted the clinic to hire physicians who displayed patient-focused emotion. We discuss implications of perceiving physicians as empty vessels for health care.

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confidence: 95%

The “Empty Vessel” Physician

Schroeder

Fishbach

2015

Social Psychological and Personality Science

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“…Previous studies have shown, for example, that patients have negative perceptions of the competence of physicians who utilize computerized clinical decision support tools. 40,41 Such perceptions may make both physicians and patients reluctant to use these tools. Our own work has also suggested that patients’ utilization of personalized prognostic information is limited by their lack of experience with using such information, a tendency to favor heuristic-over risk-based decision making strategies, and perceptions that model-derived risk information is less valuable than other types of evidence (e.g., emotions, recommendations of trusted physicians, personal narratives).…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Physicians’ Intentions to Communicate Personalized Prognostic Information to Cancer Patients at the End of Life

et al. 2016

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Purpose To explore the effects of personalized numeric prognostic information on physicians’ intentions to communicate prognosis to cancer patients at the end of life, and to identify factors that moderate these effects. Methods A factorial experiment was conducted in which 93 Family Medicine physicians were presented with a hypothetical case vignette depicting an end-stage gastric cancer patient seeking prognostic information. Physicians’ intentions to communicate prognosis were assessed before and after provision of personalized prognostic information, while emotional distress of the patient and ambiguity (manifest by imprecision) of the prognostic estimate were varied between subjects. General linear models were used to test the effects of personalized prognostic information, patient distress, and ambiguity on prognostic communication intentions, and explored potential moderating effects of: 1) perceived patient distress, 2) perceived credibility of prognostic models, 3) physician numeracy (objective and subjective), and 4) physician aversion to risk and ambiguity. Results Provision of personalized prognostic information increased prognostic communication intentions (p<.001, η2=.38), although experimentally-manipulated patient distress and prognostic ambiguity had no effects. Greater change in communication intentions was positively associated with higher perceived credibility of prognostic models (p=.007, η2=.10), higher objective numeracy (p=.01, η2=.09), female sex (p=.01, η2=.08), and lower perceived patient distress (p=.02, η2=.07). Intentions to communicate available personalized prognostic information were positively associated with higher perceived credibility of prognostic models (p=.02, η2=.09), higher subjective numeracy (p=.02, η2=.08), and lower ambiguity aversion (p=.06, η2=.04). Conclusions Provision of personalized prognostic information increases physicians’ prognostic communication intentions to a hypothetical end-stage cancer patient, and situational and physician characteristics moderate this effect. More research is needed to confirm these findings and to elucidate the determinants of prognostic communication at the end of life.

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“…Research also started investigating DST’s social influence. A lab experiment shows that physicians are concerned patients would think less of them and their skills if they needed a tool to make medical decisions [37]; Poor concern for clinician needs: Clinicians often lack the motivation to use a DST [22, 40]. They see it as getting in their way and slowing them down.…”

Section: Related Workmentioning

confidence: 99%

Section: Related Workmentioning

confidence: 99%

Investigating the Heart Pump Implant Decision Process

Yang

Zimmerman

Steinfeld

et al. 2016

Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems

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Clinical decision support tools (DSTs) are computational systems that aid healthcare decision-making. While effective in labs, almost all these systems failed when they moved into clinical practice. Healthcare researchers speculated it is most likely due to a lack of user-centered HCI considerations in the design of these systems. This paper describes a field study investigating how clinicians make a heart pump implant decision with a focus on how to best integrate an intelligent DST into their work process. Our findings reveal a lack of perceived need for and trust of machine intelligence, as well as many barriers to computer use at the point of clinical decision-making. These findings suggest an alternative perspective to the traditional use models, in which clinicians engage with DSTs at the point of making a decision. We identify situations across patients’ healthcare trajectories when decision supports would help, and we discuss new forms it might take in these situations.

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Why Do Patients Derogate Physicians Who Use a Computer-Based Diagnostic Support System?

Cited by 83 publications

References 20 publications

The “Empty Vessel” Physician

The “Empty Vessel” Physician

Factors Affecting Physicians’ Intentions to Communicate Personalized Prognostic Information to Cancer Patients at the End of Life

Investigating the Heart Pump Implant Decision Process

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