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How surgeons design treatment recommendations in orthopaedic surgery
Pamela L Hudak1, Shannon J Clark, Geoffrey Raymond
1St Michael's Hospital, Department of Medicine, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. plhudak@gmail.com
Social Science & Medicine (1982)
|August 23, 2011
Summary
Orthopaedic surgeons tailor treatment recommendations, but surgical options are presented simply and early. Non-surgical options are more complex, reflecting an institutional bias towards surgery.
Area of Science:
- Medical Communication
- Health Services Research
- Sociology of Health
Background:
- Surgeons adapt treatment recommendations based on patient cues.
- Previous research indicates potential asymmetries in recommendation design.
Purpose of the Study:
- To analyze how orthopaedic surgeons design treatment recommendations considering patient expectations.
- To identify asymmetries in how surgical versus non-surgical treatment options are presented.
Main Methods:
- Qualitative analysis of surgeon-patient interactions during treatment recommendation discussions.
- Examination of the linguistic and structural features of surgical and non-surgical recommendations.
Main Results:
- Recommendations for surgery are typically presented early, simply, and directly.
- Non-surgical recommendations are often delayed, indirect, complex, and include justifications and alternatives.
- Surgeons' strategies for addressing patient resistance vary based on the recommendation type.
Conclusions:
- A tension exists between patient-centered recommendation design and an institutional bias favoring surgery.
- Patients actively co-construct treatment recommendations through their explicit and tacit input.
- Understanding these dynamics is crucial for improving shared decision-making in orthopaedic care.
