23 February 2007
The decision-making of physicians is based on their special expertise, but the influence of patients on problem-solving can also be substantial in many situations. As support for compliance with care, physicians endeavour in accordance with their possibilities to prescribe medications desired by patients. This information emerges in Problem Solving within Professional Services: A Study of Physicians’ Prescribing Decisions, a thesis study by Elina Jaakkola, Master of Economic Sciences. This thesis study, respective to the marketing field, shall be examined at Turku School of Economics on Friday, 2 March 2007.
According to this study, the impact of patients on prescription decisions is frequently substantial. The information provided by the patient about his/her symptoms and health status significantly affects the physician’s solutions. The physician must adapt his/her professional perspective so that it merges with the preconceptions formed by patients with regard to various medications.
Elina Jaakkola states: ”According to the understanding physicians, the ability and desire to participate in treatment decisions varies from one patient to another. The participation of patients is common, particularly with regard to the sort of illnesses that have been in the fore in the media or in advertising. As support for compliance with care, the physicians often try to prescribe medications in accordance with their patients’ wishes, as long as there is no medical obstacle to doing so.”
For the doctoral thesis, over 90 physicians in five countries have been interviewed in three interview studies. The majority of the interviews have been conducted in the United States, Great Britain and Finland. The physicians’ perspectives were clarified in interview studies dealing with the influential factors on prescription decisions. Both specialized physicians and general practitioners were amongst the group interviewed. In addition, Ms Jaakkola completed a systematic survey of research studies published in the medical field that examine the factors impacting prescription-related decisions by physicians.
Physicians under pressure conflicts from many quarters
Autonomy and altruism – features connected with professions that have achieved a special position in the community – are, according to the study, in conflict with physicians’ daily reality. In their practical jobs, physicians function under pressure conflicts from the wishes and orders of patients, the employer organization, pharmaceutical firms and the authorities. Physicians’ personal benefits and working conditions also affect problem-solving. Moreover, influence derives from the experiences and opinions of colleagues.
”The traditional idea of a public-serving professional who does not seek his or her own benefit does not necessarily find its niche in highly competitive and rapidly changing markets,” Ms Jaakkola points out.
In Finland, medication price is not a decisive factor
In the study, it was observed that physicians in various countries regard various criteria as important in the selection of pharmaceuticals. For example, physicians in Great Britain relate that the price of the medication is an important factor affecting decision-making, due to clinics’ budget pressures. On the other hand, in Finland – in which the patient must pay for medications – physicians rarely emphasize the impact of price on decisions. The desire of physicians to realize patients’ wishes also appears to depend on the competition-related circumstances: patient satisfaction is more important for private practitioners than for public health care units struggling with long patient queues.
The study provides actors in the pharmaceutical field with an overall picture of the multilateral character of prescription decisions. It is shown in the study that the impact of patients can be strong, also in the selection of prescription drugs. Consumers of public health services are becoming more and more aware and more willing to participate in decisions associated with their health. Consultation skills in dealing with the patient are, indeed, a pivotal part of the physician’s professional skill.
The viewpoints and experiences of the service provider – the physicians – make up the central core of Elina Jaakkola’s thesis study. The previous service study is concentrated on describing the generation of service on the general level, with regard to which the special features of knowledge-intensive specialist services have not been taken into consideration. Traditionally, services have also been studied from the client’s perspective instead of the producer’s.
The doctoral thesis can be read at:
http://info.tse.fi/julkaisut/vk/Ae2_2007.pdf
Additional information:
Elina Jaakkola
+358 44 510 9499, elina.jaakkola(a)invenire.fi