Decision making by cardiac patients: implications for risk management

Social and cultural changes and media scrutiny have led to increased public awareness of the patient’s role in medical care. Decisions are no longer directed by physicians alone and are affected by several nonmedical factors. In the current environment, physicians must respond actively to how patients perceive their care and how they make decisions about themselves to aid in risk management. Patients and families with high-risk profiles for litigation have been identified, and it is important to be aware of these subsets. Gender differences and patients’ hidden histories can affect their decision making and relationships with physicians. Mistaken concepts about medical care, patients’ beliefs in alternative medical treatments, and patients’ magical beliefs must also be considered in assessing communication with patients and their families, and are useful in constructing a risk-management strategy. Factors contributing to malpractice suits and a proposed risk-reduction protocol that physicians can follow to decrease legal risk are also discussed.