Choosing Doctors Wisely

Can Assisted Choice Enhance Patients' Selection of Clinicians?

Published in: Medical Care Research and Review [Epub November 2017]. doi:10.1177/1077558717743822

Posted on RAND.org on January 24, 2018

by Steven Martino, Rachel Grob, Sarah Davis, Andrew M. Parker, Melissa L. Finucane, Jennifer L. Cerully, Lise Rybowski, Dale Shaller, Mark Schlesinger

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This article was published outside of RAND. The full text of the article can be found at the link above.

We conducted a simulated clinician-choice experiment, comparing choices and decision-making processes of participants (N = 688) randomized among four experimental arms: a conventional website reporting only quantitative performance information, a website reporting both qualitative (patient comments) and quantitative information, the second website augmented by a decision aid (labeling of patient comments), and the decision-aided website further augmented by the presence of a trained navigator. Introducing patient comments enhanced engagement with the quality information but led to a decline in decision quality, particularly the consistency of choices with consumers' stated preferences. Labeling comments helped erase the decline in decision quality, although the highest percentage of preference-congruent choices was seen in the navigator arm. Engagement with the quality information and satisfaction with choices available were likewise highest in the navigator arm. Findings held for high- and low-skilled decision makers. Thus, navigator assistance may be a promising strategy for equitably promoting higher quality choices in information-rich contexts.

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