Factors predicting surgeons' preferred and actual roles in interactions with their patients.

BACKGROUND: Although shared decision making offers clinical benefits, there is a lack of research investigating physicians' roles in interactions with their patients. Research examining what characterizes physicians who involve patients in decision making is also limited. The authors investigated surgeons' preferred and usual roles in interactions with patients, and whether these roles are influenced by their gender, experience, area of expertise, numeracy, and cultural background. METHODS AND RESULTS: Participants were a diverse sample of 292 surgeons from 60 countries. Surgeons completed a survey about their usual and preferred roles in medical decision making. They also completed the Berlin Numeracy Test-a brief instrument designed to measure numeracy in culturally diverse educated individuals. Most surgeons preferred to share decision making with patients, but very few reported having a collaborative role in typical interactions. Female surgeons showed a stronger preference for collaborative decision making than their male counterparts (OR = 2.08). However, female surgeons more often played an active role in medical decision making, involving patients less often (OR = 5.39). Surgeons with low numeracy (OR = 3.83), less experienced surgeons (OR = 3.15), and surgeons from individualistic countries (OR = 1.82) rarely involved patients in decision making. CONCLUSIONS: Most surgeons reported that shared decision making was their preferred method for medical decision making. Unfortunately, many of them were insufficiently equipped to take a more collaborative role in interactions with patients. Gender, numeracy, length of experience, and cultural background limited their willingness to collaborate. Future research should identify effective interventions that help overcome barriers to shared decision making.