Individuals faced with the prospect of choosing a new doctor consider a variety of factors when making their decision. Experience, recommendations from friends and family, specialized training, location, convenience and quality of medical education are just a few of the factors that may run through patients’ minds after receiving a diagnosis. Given that choosing a physician and a treatment are among the most important choices that cancer patients will make, researchers recently looked into how patients make these decisions.
Timothy Pawlik is Chief of the Division of Surgical Oncology at Johns Hopkins Hospital and a member of the Johns Hopkins Kimmel Cancer Center. He was one of the researchers who interviewed 214 patients with a cancer diagnosis seeking treatment at the hospital and published the resulting data in November’s Annals of Surgical Oncology.
The patients had a median age of 62 and the most common diagnoses were breast cancer or hepatobiliary cancer (involving the liver, pancreas, gallbladder or bile ducts).
Based on other published findings, the researchers narrowed down a list of potential influences on the choice of a cancer surgeon to 16 factors. Examples of these factors include the reputation of a physician, especially among friends and family, the number of years a physician has been working and even the availability of parking spaces near the hospital. The patients ranked the factors using the best-worst scaling method, in which they selected the favorability of each of the different attributes.
The result? When asked about their preferences for a cancer surgeon, 75.3 percent stated that ideally, their surgeon had performed the procedure they would be receiving at least 50 times, and 68.1 percent of patients preferred their surgeon to have six years of experience at minimum. Patients held physician qualifications and hospital-related factors as most important. Specifically, the experience of the surgeon with the procedure and specialized training that the surgeon underwent were very important.
In terms of hospital-related factors, the number of procedures performed in the hospital was very important. The least important factors were the distance the patient would have to travel to the hospital, the availability of parking spaces and ratings of the surgeon found on the Internet. The rankings were similar even when education levels, types of cancer and number of visits to the clinic differed. The patients were also stratified by state of residence, and the order of the rankings remained unchanged.
A separate study shows that these beliefs may be based on actual facts, as cancer surgeons who are more experienced in a particular procedure typically have better outcomes. As for future research in this field, Pawlik believes that patients equipped with the surgery rates and outcomes of individual physicians may feel better prepared in making decisions.
While research on these factors is very important, organizations such as the American Cancer Society recommend asking the diagnosing physician, “If you found out that you or someone you loved had this cancer, which doctor would you go to for treatment?” The physician will often recommend another doctor even if the patient does not ask for one, and this doctor can provide a second opinion.
