Effective communication between doctors and their patients is essential to successful medication choices and treatments. Our interest in this exploratory paper lies in the quality of communication between doctors and patients: what both parties seek to explain and what they commonly understand, what opportunities and what frictions occur as a result of their respective goals, what gaps exist in their knowledge bases, and how information of different types influences health risks and medication choices. The data reported in this paper come from conversations with doctors about how they communicate with patients when discussing the benefits and risks of prescription medications, and from patients who talked with us about their concerns and the perceived quality of their communications with physicians. Overall, we were surprised by the failure of the assumed decision-making models to explain much of what we heard and observed. In response, we advance a structured decision-making framework, based on decision analysis and value-focused thinking, that provides both descriptive and prescriptive models of physician–patient communication intended to assist in the development of improved communication standards concerning health risk assessments and medication choices.
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