Study: Patients feeling intimidated during physician visits may act like hostages

Fearful or confused patients may feel helpless and like they are negotiating for their healthcare, similar to how a hostage would feel, according to a recent study.

For the report, researchers — led by Leonard Berry, PhD, a professor in the Mays Business School at Texas A&M University in College Station — analyzed prior research and patient testimonials.

Here are five takeaways from the study.

1. When patients feel intimidated by physicians, a feeling the researchers define as "hostage bargaining syndrome," it is a "real phenomenon that many patients experience, particularly those with a serious disease or in a state of great vulnerability," Dr. Berry told Reuters.

2. Despite physicians' efforts to foster active conversation, families of cancer patients and patients in intensive care units may feel dependent on physicians to direct their treatment path. When medical errors or unexpected side effects occur, this could increase feelings of powerlessness, the researchers noted.

3. "This story (of a parent whose child is receiving extended inpatient care) could just as easily be that of a 70-year-old man with coronary artery disease who is unsure about the cardiologist's recommendation for surgery but hesitates to question it, or a 27-year-old woman with cancer who does not express her fear of treatment-related infertility to her oncologist," according to the study. 

4. The study noted physician-patient relationships are not like consumer service relationships, in which customers may feel comfortable asking about bad service. Instead, healthcare can create an unequal power balance leaving the patient feeling in need of the physician. Patients exuding symptoms of hostage bargaining syndrome may "worry about being perceived as troublemakers or 'difficult' for fear that it could affect the quality of care they receive," the researchers said.

5. To combat hostage bargaining syndrome and side effects like depression and loneliness in the medical field, Dr. Berry told Reuters physicians should pursue "shared decision-making," among other strategies. Shared decision-making is when physicians provide patients treatment options and patients discuss which option they prefer.  

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