Uncertainty, Variability, and Resource Allocation in the Health Care Decision Process

Health psychology has played a tentative role in the enterprise of health care. Health psychologists have concerned themselves with how patients adapt to illness or how psychological factors might contribute to a medical diagnosis (Friedman, 2002; Sarafino, 2002; Taylor, 1999). They have also studied how diagnosis affects mood, cognitive functioning, and other psychological variables. It is typically assumed that diagnoses are correct and that all patients placed in diagnostic categories should receive treatment. Considerable effort has been devoted to training patients to adhere to physician orders or instructions. It is assumed that physician orders describe the most likely path to positive patient outcomes. Rarely has the patient’s perspective been given equal consideration. For example, health psychology devotes insufficient attention to whether treatment results in improved health, damaged health through side effects, or reduced financial resources, or to how patients can gain equal partnership in decisions concerning their medical care.