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The myth of agency and patient choice in health care? The case of drug treatments to prevent coronary disease

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  • Bryan, Stirling
  • Gill, Paramjit
  • Greenfield, Sheila
  • Gutridge, Kerry
  • Marshall, Tom

Abstract

Patient choice is at the heart of health-care reform programmes in the UK and in many other countries. The success of patient choice initiatives is dependent on a well-functioning agency relationship in health care. We interviewed 197 patients from 13 general practices in the West Midlands, UK, both before and after coronary screening. Our study suggests that, for patients presenting for coronary risk screening in primary care, the agency relationship is not working well--patients' expressed preferences relating to decisions to commence drug treatments were largely over-ridden in the clinical consultation. Therefore, if choice is to be a real driver of change in health care it needs to encompass patient empowerment and be based on a more collaborative approach to decision making between patients and professionals.

Suggested Citation

  • Bryan, Stirling & Gill, Paramjit & Greenfield, Sheila & Gutridge, Kerry & Marshall, Tom, 2006. "The myth of agency and patient choice in health care? The case of drug treatments to prevent coronary disease," Social Science & Medicine, Elsevier, vol. 63(10), pages 2698-2701, November.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:10:p:2698-2701
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    References listed on IDEAS

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    1. Vick, Sandra & Scott, Anthony, 1998. "Agency in health care. Examining patients' preferences for attributes of the doctor-patient relationship," Journal of Health Economics, Elsevier, vol. 17(5), pages 587-605, October.
    2. Gafni, Amiram & Charles, Cathy & Whelan, Tim, 1998. "The physician-patient encounter: The physician as a perfect agent for the patient versus the informed treatment decision-making model," Social Science & Medicine, Elsevier, vol. 47(3), pages 347-354, August.
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    Cited by:

    1. Mohammed A. Mohammed & Charlotte El Sayed & Tom Marshall, 2012. "Patient and Other Factors Influencing the Prescribing of Cardiovascular Prevention Therapy in the General Practice Setting With and Without Nurse Assessment," Medical Decision Making, , vol. 32(3), pages 498-506, May.
    2. Emily Lancsar & Jordan Louviere, 2008. "Conducting Discrete Choice Experiments to Inform Healthcare Decision Making," PharmacoEconomics, Springer, vol. 26(8), pages 661-677, August.

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