PREFERENCES FOR AUTONOMY WHEN PATIENTS ARE PHYSICIANS

Objective:To assess physicians' preferences for patient autonomy when they are patients themselves. Design:Data from practicing physicians attending a continuing medical education course were obtained by questionnaire. After adjustment for sociodemographic differences, data from the physician population were compared with similar data previously obtained from a patient population. Participants:One bundred fifty-one physicians (94% of the study population) agreed to participate. Ninety percent were primary care physicians. Fifty-eight percent practiced in the eastern United States. Main results:The physicians, like the regular patients, preferred that the principal role in decision making for their own illnesses be bandled by their providers, not by themselves. As illness severity increased, physicians indicated significantly less desire for making decisions (p<0.01). The magnitudes of the effects of increasing illness severity upon the decision-making preferences of physician and regular patients were comparable (p=0.53). Physicianpatients, however, were slightly more interested than regular patients in making decisions (p<0.001). Conclusions:Although physician-patients are slightly more interested than regular patients in making decisions, for the most part their preferences for autonomy resemble those of regular patients. These results suggest that medical knowledge and sociocultural factors are only minor determinants of patient attitudes towards autonomy. Rather, patients' preferences to be relieved of decision-making responsibility are better understood as part of the phenomenology of illness. © 1987 Society of General Internal Medicine.