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Academia and the Profession |

Sociologic Influences on Decision-Making by Clinicians

JOHN M. EISENBERG, M.D.
[+] Article and Author Information

This study was supported in part by The Robert Wood Johnson Foundation Clinical Scholars Program, Princeton, New Jersey; the National Health Care Management Center at the Leonard Davis Institute of Health Economics at the University of Pennsylvania (which is supported by grant HS 02577, National Center for Health Services Research); and the Solomon Katz Chair in General Medicine at the University of Pennsylvania.

The opinions and conclusions in this article are those of the author and do not necessarily represent those of The Robert Wood Johnson Foundation, the National Health Care Management Center, or the Leonard Davis Institute of Health Economics.

▸Requests for reprints should be addressed to John M. Eisenberg, M.D.; 3 Silverstein Pavilion, Hospital of the University of Pennsylvania, 3400 Spruce Street; Philadelphia, PA 19104.


Philadelphia, Pennsylvania


© 1979 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1979;90(6):957-964. doi:10.7326/0003-4819-90-6-957
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Recent articles on clinical decision-making have proposed sophisticated quantitative methods for improving the physician's clinical judgment. Actual clinical decisions, however, are influenced by interactions between the clinician, the patient, and the sociocultural milieu as well as by biomedical considerations. This paper explores these sociologic influences on the decision-making process. Four types of sociologic factors influence the clinician's judgment: the characteristics of the patient; the characteristics of the clinician; the clinician's interaction with his profession and the health care system; and the clinician's relationship with the patient. To illustrate sociologic influences on clinical decision-making, this paper presents observations from the literature of sociology, clinical psychology, psychiatry, and medicine. Further studies are needed to provide additional empirical information.

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