Regulatory focus affects physician risk tolerance

Abstract

Risk tolerance is a source of variation in physician decision-making. This variation, if independent of clinical concerns, can result in mistaken utilization of health services. To address such problems, it will be helpful to identify nonclinical factors of risk tolerance, particularly those amendable to intervention-regulatory focus theory suggests such a factor. This study tested whether regulatory focus affects risk tolerance among primary care physicians. Twenty-seven primary care physicians were assigned to promotion-focused or prevention-focused manipulations and compared on the Risk Taking Attitudes in Medical Decision Making scale using a randomization test. Results provide evidence that physicians assigned to the promotion-focus manipulation adopted an attitude of greater risk tolerance than the physicians assigned to the prevention-focused manipulation (p = 0.01). The Cohen's d statistic was conventionally large at 0.92. Results imply that situational regulatory focus in primary care physicians affects risk tolerance and may thereby be a nonclinical source of practice variation. Results also provide marginal evidence that chronic regulatory focus is associated with risk tolerance (p = 0.05), but the mechanism remains unclear. Research and intervention targeting physician risk tolerance may benefit by considering situational regulatory focus as an explanatory factor.

Keywords: Regulatory Focus Theory; medical decision making; primary care; risk tolerance.

Figure 1.

Models of the relationship between situation, regulatory focus, risk tolerance and risk perception. A) is a simplification of the Bryant and Dunford model; B) is the proposed alternative. Both models only include the key relationships under discussion in this study - additional arrows are not shown.

Figure 2.

Adjusted means for the risk attitude scores across groups defined by chronic and situational regulatory focus groups. Lower values on the risk attitude scale correspond to greater risk attitudes. The Cohen’s d effect size for the groups defined by chronic regulatory focus is 0.42. The Cohen’s d effect size for the groups defined by the situational regulatory focus manipulations is 0.92.