Abstract
The medical consultation is best understood as a two-way social interaction involving interactive decision making. Game theory—a theory based on assumptions of rational choice and focusing on interactive decision making—has the potential to provide models of the consultation that can be used to generate empirically testable predictions about the factors that promote quality of care. Three different game structures—the Prisoner's Dilemma game, the Assurance game, and the Centipede game—all provide insights into the possible underlying dynamics of the doctor-patient interaction. Further empirical work is needed to uncover the underlying game structures that occur most commonly in medical consultations. Game theory has the potential to provide a new conceptual and theoretical basis for future empirical work on the interaction between doctors and their patients.
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Selected References
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- Batifoulier P. L'interaction médecin-patient: un examen par la théorie des jeux. Cah Sociol Demogr Med. 1997 Jul-Dec;37(3-4):341–364. [PubMed] [Google Scholar]
- Charles C., Gafni A., Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997 Mar;44(5):681–692. doi: 10.1016/s0277-9536(96)00221-3. [DOI] [PubMed] [Google Scholar]
- Colman Andrew M. Cooperation, psychological game theory, and limitations of rationality in social interaction. Behav Brain Sci. 2003 Apr;26(2):139–198. doi: 10.1017/s0140525x03000050. [DOI] [PubMed] [Google Scholar]
- Diamond G. A., Rozanski A., Steuer M. Playing doctor: application of game theory to medical decision-making. J Chronic Dis. 1986;39(9):669–682. doi: 10.1016/0021-9681(86)90148-7. [DOI] [PubMed] [Google Scholar]
- Elwyn G., Edwards A., Kinnersley P. Shared decision-making in primary care: the neglected second half of the consultation. Br J Gen Pract. 1999 Jun;49(443):477–482. [PMC free article] [PubMed] [Google Scholar]
- Fehr Ernst, Gächter Simon. Altruistic punishment in humans. Nature. 2002 Jan 10;415(6868):137–140. doi: 10.1038/415137a. [DOI] [PubMed] [Google Scholar]
- Gray Denis Pereira, Evans Philip, Sweeney Kieran, Lings Pamela, Seamark David, Seamark Clare, Dixon Michael, Bradley Nicholas. Towards a theory of continuity of care. J R Soc Med. 2003 Apr;96(4):160–166. doi: 10.1258/jrsm.96.4.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hockstra D. J., Miller S. D. Sequential games and medical diagnosis. Comput Biomed Res. 1976 Jun;9(3):205–215. doi: 10.1016/0010-4809(76)90001-x. [DOI] [PubMed] [Google Scholar]
- O'Dowd T. C. Five years of heartsink patients in general practice. BMJ. 1988 Aug 20;297(6647):528–530. doi: 10.1136/bmj.297.6647.528. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Palombo S. R. The prisoner's dilemma: game theory and the therapeutic alliance. Psychoanal Q. 1997 Oct;66(4):628–641. [PubMed] [Google Scholar]
- Stevenson F. A., Barry C. A., Britten N., Barber N., Bradley C. P. Doctor-patient communication about drugs: the evidence for shared decision making. Soc Sci Med. 2000 Mar;50(6):829–840. doi: 10.1016/s0277-9536(99)00376-7. [DOI] [PubMed] [Google Scholar]