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Medical Decision Making
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Do Physicans Have a Bias toward Action?

A Classic Study Revisited

John Z. Ayanian, MD, MPP

Donald M. Berwick, MD, MPP

In an attempt to replicate the findings of a classic study of medical decision making, the authors studied decision making in modern pediatrics practice. They prepared case scenarios and surveyed pediatricians for three common clinical decisions: tympanostomy tube place ment, radiography orders, and emergency room referrals. Initial reviewers rated the cases according to the likelihoods that they would take the clinical actions mentioned. Subsequently, other physicians presented with a subset of scenarios in which the initial reviewers were least likely to act tended to be more active in the tympanostomy (p = 0.004) and radiography (p = 0.076) decisions. In these cases the physicians appeared to have a bias toward action. For a subset of scenarios in which the initial reviewers were most likely to act, subsequent reviewers were neither more nor less likely to act than the initial reviewers. (Med Decis Making 1991 ;11 :154-158)

Medical Decision Making, Vol. 11, No. 3, 154-158 (1991)
DOI: 10.1177/0272989X9101100302
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