title: A signal detection approach to patient-doctor communication and doctor-shopping behaviour among Japanese patients.
abstract: OBJECTIVE
  As one of the factors related to doctor-shopping behaviour (i.e. consulting multiple doctors with regard to the same illness episode), very little has been revealed about the role of doctor explanation. We examined therefore the association between doctor explanation and doctor-shopping behaviour.
  
  
  METHODS
  The subjects were internist-patient pairs in Japan. Signal detection analysis (SDA) was used for the data analysis.
  
  
  RESULTS
  Of the 303 patients, 84 patients engaged in doctor shopping (27.7%). The following results were obtained: (1) of the 19 relevant variables, the 'level of doctor explanation: treatment' was the most significant predictor of doctor-shopping behaviour (P < 0.01), and (2) with regard to their subjective evaluations of the sufficiency of their explanations about treatment or testing, the evaluations of the doctors, rather than those of the patient, were significant predictors of doctor-shopping behaviour.
  
  
  CONCLUSIONS
  These results imply the following: (1) a patient's inability to understand a doctor's explanation about treatment, which results from a large gap between the perceptions of the patient and those of the doctor, is the most significant predictor of doctor-shopping behaviour, and (2) in the context of favourable patient-doctor interactions, when doctors feel their explanations are insufficient, they may be able to prevent doctor-shopping behaviour by providing relatively thorough explanations about treatment.
authors.affiliation: Department of Health Services Management and Policy, Graduate School of Medicine, Kyushu University, 3-1-1 Maidashi, Fukuoka, Japan. hagihara@hsmp.med.kyushu-u.ac.jp
authors.forename: Akihito
authors.initials: A
authors.lastname: Hagihara
authors.forename: Kimio
authors.initials: K
authors.lastname: Tarumi
authors.forename: Misato
authors.initials: M
authors.lastname: Odamaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Nobutomo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003142:Communication; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations