title: Effects of systematic asymmetric discounting on physician-patient interactions: a theoretical framework to explain poor compliance with lifestyle counseling.
abstract: BACKGROUND
  This study advances the use of a utility model to model physician-patient interactions from the perspectives of physicians and patients.
  
  
  OBJECTIVE
  In cases involving acute care, patient counseling involves a relatively straightforward transfer of information from the physician to a patient. The patient has less information than the physician on the impact the condition and its treatment have on utility. In decisions involving lifestyle changes, the patient may have more information than the physician on his/her utility of consumption; moreover, differences in discounting future health may contribute significantly to differences between patients' preferences and physicians' recommendations.
  
  
  METHODS
  The expectation of differences in internal discount rate between patients and their physicians is discussed.
  
  
  CONCLUSIONS
  This utility model provides a conceptual basis for the finding that educational approaches alone may not effect changes in patient behavior and suggests other economic variables that could be targeted in the attempt to produce healthier behavior.
authors.affiliation: Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, USA. sfeldman@wfubmc.edu
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: G John
authors.initials: GJ
authors.lastname: Chen
authors.forename: Judy Y
authors.initials: JY
authors.lastname: Hu
authors.forename: Alan B
authors.initials: AB
authors.lastname: Fleischer
mesh_terms: D000367:Age Factors; D003661:Decision Support Techniques; D037001:Directive Counseling / Q000639:trends*; D006801:Humans; D016013:Likelihood Functions; D008490:Medical Informatics; D008960:Models, Psychological; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods; D010817:Physician-Patient Relations; D040242:Risk Reduction Behavior; D012309:Risk-Taking