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A Piece of My Mind
March 22/29, 2016

The Power of “My”

Author Affiliations
  • 1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA. 2016;315(12):1235. doi:10.1001/jama.2015.17153

The phrase “my doctor” implies a relationship that is key to the practice of medicine. Understanding the implications of this relationship is vitally important, particularly in this time of rapid change in the structure of medical practice.

Some years ago, as a young research fellow,I wanted to determine the relationship, if any, between the use of technology, diagnostic tests, and patient satisfaction.

My simple hypothesis: If a patient expected a particular diagnostic test and the physician prescribed it, the patient would be more satisfied than a patient with similar expectations whose physician did not prescribe the “expected” test. The hypothesis still widely believed by many physicians. The surprising result for me was that I could not demonstrate the validity of the hypothesis. More specifically, any relationship between a diagnostic test being done or not and a patient’s expectation was overwhelmed statistically by the patient’s expectation that the physician “explain things.” The expectation of “explanation” by the physician mattered much more than any test or, indeed, anything I was able to measure.

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