. Author manuscript; available in PMC: 2019 Apr 12.

Published in final edited form as: Clin Pediatr (Phila). 2017 Apr 21;56(11):993–1000. doi: 10.1177/0009922817702939

Table 3.

Physician perspectives on communication and decision-making between physicians and families

Theme	Sample quotations
Information-sharing	• “I always tell people…surgery is very effective. It’s quick. It gives you very immediate results but surgery has its problems and I list the morbidity of surgery. What I normally say to them is, what we’re here to do is decide whether the problems your child has justify putting him through a surgery which is common but does have problems associated with it.” – Pediatric otolaryngologist • “I always warn parents that it’s terrible…I’m like, ‘It’s really painful. You’re not going to eat for a couple of days.’ If they’re going through with it, I’d rather them expect the worst and then be like, ‘Oh it wasn’t so bad,’ than to be shocked at how horrible this is.” -- Pediatrician • “The kid’s got sleep apnea but your child has a one in 30 thousand risk of death. You can’t synthesize that information.” – Otolaryngologist
Decision-making and parent engagement	• “In our patient population they’re like, ‘Whatever you say, doctor, that’s what I’m going to do.” -- Pediatrician • “The less informed the parent is, the more you are likely to make the decision for them.” – Pediatric otolaryngologist • “The patients who start asking a lot of questions are engaged in the process…the number one thing I look for is somebody who is asking a lot of questions.” – Pediatric otolaryngologist • “The first thing is who is showing up to the visit? Typically more engaged parents, both parents are there. And not only there, when I say there, I mean engaged in the conversation and the questions and so on.” – Pediatric otolaryngologist • “It’s hard to tell because it could just be the way they deal with stress, talk don’t talk about it, but there are some where you know, like the dad sleeping in the chair when the kid is sitting there ready for surgery and the kid is nervous, but the dad doesn’t care.” -- Anesthesiologist • “Sometimes it’s just getting them to actually engage at a time when they wouldn’t otherwise. It’s also making sure they understand.” -- Pediatrician

Theme

Sample quotations

Information-sharing

• “I always tell people…surgery is very effective. It’s quick. It gives you very immediate results but surgery has its problems and I list the morbidity of surgery. What I normally say to them is, what we’re here to do is decide whether the problems your child has justify putting him through a surgery which is common but does have problems associated with it.” – Pediatric otolaryngologist
• “I always warn parents that it’s terrible…I’m like, ‘It’s really painful. You’re not going to eat for a couple of days.’ If they’re going through with it, I’d rather them expect the worst and then be like, ‘Oh it wasn’t so bad,’ than to be shocked at how horrible this is.” -- Pediatrician
• “The kid’s got sleep apnea but your child has a one in 30 thousand risk of death. You can’t synthesize that information.” – Otolaryngologist

Decision-making and parent engagement

• “In our patient population they’re like, ‘Whatever you say, doctor, that’s what I’m going to do.” -- Pediatrician
• “The less informed the parent is, the more you are likely to make the decision for them.” – Pediatric otolaryngologist
• “The patients who start asking a lot of questions are engaged in the process…the number one thing I look for is somebody who is asking a lot of questions.” – Pediatric otolaryngologist
• “The first thing is who is showing up to the visit? Typically more engaged parents, both parents are there. And not only there, when I say there, I mean engaged in the conversation and the questions and so on.” – Pediatric otolaryngologist
• “It’s hard to tell because it could just be the way they deal with stress, talk don’t talk about it, but there are some where you know, like the dad sleeping in the chair when the kid is sitting there ready for surgery and the kid is nervous, but the dad doesn’t care.” -- Anesthesiologist
• “Sometimes it’s just getting them to actually engage at a time when they wouldn’t otherwise. It’s also making sure they understand.” -- Pediatrician