Several developments in health care in recent years have focused attention on the patient's role in his or her own health care. Patients are demanding greater participation in the decision making that surrounds their care. More and more of the finan cial responsibility for their care falls on their own shoulders. Drug companies promote their products through the lay media directly to patients, bypass ing their physicians. This approach is intended to create demand by changing patients' preferences for the benefits offered by the products. The role of health maintenance organizations (HMOs) in lim iting access to specialists, to expensive investiga tions, and to such high-tech treatments as bone marrow transplantation is under legislative assault as patients demand that their reasonable prefer ences be met. It is important to emphasize that this review does not focus on the population level policy deci sions reflected above but on the individual health care choices made by patients. In practice, physi cians make decisions all day as they choose tests and treatments, select screening tests, and help patients manage chronic as well as life-threatening diseases. Most decisions are made in the face of uncertainty in the sense that the outcome of the action they select is unknown.
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Thomas R. Taylor (2000) studied this question.