Patient and physician characteristics influencing medical decisions in asthma.

The present study explores the complex interplay of objective indices of illness-severity and personal characteristics of patients and physicians as they influence judged illness-severity and medical decisions concerning length of hospitalization and intensity of prescribed oral corticosteroids in a chronic asthmatic population. The results indicate that, depending on the physician's personal characteristics, he may: a) confuse his patient's psychological physical distress, resulting in medical judgment and decisions being influenced by patient personality; b) accurately distinguish between psychological physical distress but treat a psychological problem as though it were a medical problem; c) judge and treat the patient's illness objectively, regardless of the patient's personality. These findings stress the importance of expanding the present biomedical model of medicine to include a better appreciation of how social, psychological, and behavioral factors influence the medical decisions about treatment and the resulting outcome.