When do doctors follow patients' orders? Organizational mechanisms of physician influence

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11 Scopus citations

Abstract

Physicians, like other professionals, are expected to draw from specialized knowledge while remaining receptive to clients' requests. Using nationally representative U.S. survey data from the Community Tracking Study, this paper examines the degree to which physicians are influenced by patients' requests, and how physicians' workplaces may mediate acquiescence rates through three mechanisms: constraints, protection, and incentives. We find that, based on physicians' reports of their responses to patients' suggestions, patient influence is rare. This influence is least likely to be felt in large workplaces, such as large private practices, hospitals, and medical schools. We find that the protection and incentives mechanisms mediate the relationship between workplace types and physician acquiescence but more prescriptive measures such as guidelines and formularies do not affect acquiescence. We discuss these findings in light of the ongoing changes in the structure of medicine.

Original languageEnglish (US)
Pages (from-to)171-184
Number of pages14
JournalSocial Science Research
Volume48
DOIs
StatePublished - Nov 2014
Externally publishedYes

Keywords

  • Hospitals
  • Influence
  • Negotiations
  • Organizations
  • Patients
  • Physicians

ASJC Scopus subject areas

  • Education
  • Sociology and Political Science

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