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Bringing social structure back into clinical decision making.

J A Clark1, D A Potter, J B McKinlay

  • 1New England Research Institute, Inc., Watertown, MA 02172.

Social Science & Medicine (1982)
|January 1, 1991
PubMed
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Clinical decision-making is influenced by social factors like patient demographics and practice settings. A new factorial experimental design offers a better way to study these sociologic influences.

Area of Science:

  • Medical Sociology
  • Health Services Research
  • Clinical Psychology

Background:

  • Dominant research on clinical decision-making often overlooks the crucial social context.
  • Previous studies typically assume physician autonomy and ignore patient-physician relationships and practice setting dynamics.
  • Sociological research highlights the impact of social structures on medical practice.

Purpose of the Study:

  • To review and expand upon the understanding of sociologic influences on clinical decision-making.
  • To identify key social structural dimensions affecting physicians' decisions.
  • To propose a more robust research methodology for studying these influences.

Main Methods:

  • Review of recent studies on the social context of clinical decision-making.
Keywords:
Empirical ApproachProfessional Patient Relationship

Related Experiment Videos

  • Identification of methodological limitations in existing research (e.g., secondary data analysis, normative models, small samples).
  • Proposal of a factorial experimental design as a feasible alternative strategy.

    • Main Results:

    • Clinical decision-making is influenced by patient characteristics (age, gender, socioeconomic status, race) and physician factors (training, experience).
    • The structure of organized clinical settings significantly impacts decision processes.
    • Existing studies suffer from significant methodological limitations, hindering clear understanding.

    Conclusions:

    • Social and structural factors profoundly influence clinical decision-making.
    • A factorial experimental design can effectively disentangle complex social influences.
    • Future research should adopt rigorous methodologies to accurately assess these impacts.